- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT07711964
Identifying an Optimal Corticosteroid Dosage Regimen for Acute Respiratory Distress Syndrome
Corticosteroids for Acute Respiratory Distress Syndrome: A Proof-of-Concept Trial Exploring Biological Heterogeneity and Treatment Response
The early phase of Acute Respiratory Distress Syndrome (ARDS) is characterized by intense alveolar inflammation. Corticosteroids have been used to treat ARDS for decades. Although their efficacy has been a subject of ongoing controversy, recent clinical practice guidelines for ARDS issued a weak recommendation in favor of corticosteroid use in early ARDS. However, the optimal dose and duration of corticosteroid therapy remain unclear. Low-dose, short-course regimens have been evaluated in clinical trials for severe pneumonia and COVID-19. However, no head-to-head comparisons have been conducted to evaluate the efficacy of prolonged versus short courses of corticosteroid therapy in ARDS.
To address this gap, the investigators designed a 3×2 factorial trial to assess corticosteroid therapy for ARDS, aiming to evaluate the effects of different doses (no steroid, medium-low dose, and medium dose) and durations (prolonged vs. short) on clinical outcomes. In addition, the investigators will measure changes in inflammatory biomarkers for post hoc analysis to explore whether these biomarkers could guide the selection of steroid regimens.
Studieoversigt
Status
Betingelser
Undersøgelsestype
Tilmelding (Anslået)
Fase
- Fase 4
Kontakter og lokationer
Studiekontakt
- Navn: Sheng-Yuan Ruan, MD, PhD
- Telefonnummer: 886223123456
- E-mail: syruan@ntu.edu.tw
Studiesteder
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-
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Taipei, Taiwan, 10002
- Rekruttering
- National Taiwan University Hospital
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Kontakt:
- Research Ethics Committee of NTUH
- Telefonnummer: 886233667190
- E-mail: ntuhrec@ntuh.gov.tw
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- ARDS (as defined by the Berlin definition) with an FiO₂ of 0.5 or higher
- On invasive mechanical ventilation
- Duration of intubation less than three days
Exclusion Criteria:
- Age less than 18 years
- Required to receive steroids or considered ineligible for steroids by the primary care team
- Receiving systemic steroid therapy
- Uncontrolled gastrointestinal bleeding
- Uncontrolled infeciotn
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Faktoriel opgave
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Andet: (Arm A) No steroids
Standard care without corticosteroid therapy.
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Standard care for ARDS without corticosteroids.
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|
Andet: (Arm B) No steroids
Standard care without corticosteroid therapy.
|
Standard care for ARDS without corticosteroids.
|
|
Eksperimentel: (Arm C) Steroids with low dose for 10 days
Dexamethasone 0.1 mg/kg from day 1 to day 5 and 0.05 mg/kg from day 6 to day 10.
|
Dexamethasone: low dose for 10 days
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|
Eksperimentel: (Arm D) Steroids with low dose for 7 days
Dexamethasone 0.1 mg/kg from day 1 to day 4 and 0.05 mg/kg from day 5 to day 7.
|
Dexamethasone: low dose for 7 days
|
|
Eksperimentel: (Arm E) Steroids with medium dose for 10 days
Dexamethasone 0.2 mg/kg from day 1 to day 5 and 0.1 mg/kg from day 6 to day 10.
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Dexamethasone: medium dose for 10 days
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Eksperimentel: (Arm F) Steroids with medium dose for 7 days
Dexamethasone 0.2 mg/kg from day 1 to day 4 and 0.1 mg/kg from day 5 to day 7.
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Dexamethasone: medium dose for 7 days
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
28-day ventilator-free survival
Tidsramme: 28 days
|
Proportion of ventilator-free survival at day 28 between intervention arms (arms C, D, E, and F) and control arms (arms A and B)
|
28 days
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
28-day ventilator-free survival between low and medium dose groups
Tidsramme: 28 days
|
Proportion of ventilator-free survival at day 28 between low dose (arm C and D) and medium dose (arm E and F) of corticosteroids.
|
28 days
|
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28-day ventilator-free survival between long and short treatment duration groups
Tidsramme: 28 days
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Proportion of ventilator-free survival at day 28 between long-course treatment (arms C and E) and short-course treatment (arms D and F)
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28 days
|
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ICU mortality
Tidsramme: From ICU admission to discharge, an average of 21 days
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Proportion of death in the ICU
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From ICU admission to discharge, an average of 21 days
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60-day mortality
Tidsramme: 60 days
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Proportion of death in 60 days
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60 days
|
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Oxygenation improvement on day 7
Tidsramme: 7 days
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Proportion of patients with PaO2/FiO2 ratio > 200 mmHg on day 7
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7 days
|
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Proportion of nosocomial infection
Tidsramme: 30 days
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Proportion of nosocomial infection during hospitalization (up to 30 days)
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30 days
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Proportion of lymphocytopenia
Tidsramme: 10 days
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Proportion of lymphocytopenia in 10 days
|
10 days
|
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Hyperglycemia
Tidsramme: 10 days
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Peak blood glucose level during initial 10 days
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10 days
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Samarbejdspartnere og efterforskere
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Anslået)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 202503094MIND
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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