Polysomnography-directed Noninvasive Ventilation in Amyotrophic Lateral Sclerosis (ALS)
2020年11月10日 更新者：Columbia University
Progression of Respiratory Dysfunction in Amyotrophic Lateral Sclerosis (ALS) Patients: A Comparison of Standard of Practice vs Polysomnography-Directed Nocturnal Non-Invasive Positive Pressure Ventilation
Use of noninvasive ventilation (NIV, also known colloquially as "Bipap") has been associated in some studies with improvement in pulmonary function, quality of life and survival.
NIV is typically applied during sleep, and without the benefit of sleep study to determine the optimal settings.
The investigators have shown that when NIV is used in this fashion, failure of nocturnal oxygenation and ventilation is prominent.
This study is randomizing patients to standard application of NIV vs application guided by use of sleep study data to determine the effect of titrated therapy on pulmonary function, quality of life and survival.
研究概览
研究类型
介入性
注册 (实际的)
25
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
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New York
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New York、New York、美国、10032
- Columbia University Medical Center
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参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 至 80年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- Diagnosis of probable or definite Amyotrophic Lateral Sclerosis (ALS) per El Escorial criteria
- Between ages of 18 and 80 yrs old
Exclusion Criteria:
- Inability to clear secretions from the airway
- Life expectancy < 6 months from a comorbid condition
- Dementia sufficient to impair ability to use NIV, perform respiratory muscle pressure testing (PFTs), or complete Health-related Quality of Life (HRQOL) instruments
- Inability to follow up at the ALS Center on a regular basis
- Previously diagnosed obstructive Sleep Apnea
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：支持治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
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有源比较器：Standard NIV
Noninvasive ventilation (NIV) will be initiated and managed as per current standard of practice guided by the American Academy of Neurology (AAN) Practice Parameters (updated in 2009), in all subjects with amyotrophic lateral sclerosis (ALS) and a forced vital capacity of <50% predicted.
Sleep studies will be performed at baseline, 2 weeks, 1, 3 and 6 months, but will not influence management of the NIV.
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NIV will be initiated and managed as per current standard of practice.
Sleep studies will be performed at baseline, 2 weeks, 1, 3 and 6 months to gather data but will not influence NIV management.
NIV will be adjusted by a respiratory therapist or the subject's primary physician per waking symptoms.
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实验性的：Sleep study titrated NIV
ALS subjects in this arm, who are offered NIV for Forced Vital Capacity (FVC) <50% as per AAN Practice Parameters, will have their initial level of NIV determined polysomnographically.
They will be followed with sleep studies at 1 month, 3 months and 6 months to reassess NIV efficacy and NIV will be adjusted as necessary to optimize parameters of oxygenation and ventilation.
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Sleep studies will be performed at baseline, within 2 weeks to initially titrate NIV, and at 1, 3 and 6 months to assess NIV performance and adjust it as necessary based on oxygenation and ventilation parameters.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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Change from baseline in spirometric, respiratory muscle strength, and gas exchange measures
大体时间：Up to 6 months after starting NIV
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FVC (forced vital capacity), FEV1 (forced expiratory volume in 1 second), MIP (maximum inspiratory pressure) and MEP (maximum expiratory pressure
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Up to 6 months after starting NIV
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Duration that the Mental Component Summary (MCS) is maintained above 75% of baseline score for the Medical Outcomes Study Health Survey (SF-12)
大体时间：Up to 6 months after starting NIV
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Up to 6 months after starting NIV
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Survival
大体时间：Up to 6 months after baseline
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Whether sleep study-titrated NIV is associated with trends to improved survival, compared with standardly prescribed (non-titrated) NIV
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Up to 6 months after baseline
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Nocturnal oxygenation and ventilation
大体时间：Up to 6 months after starting NIV
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Nadir oxygen saturation, number of oxygen desaturations of 3%/hr (ODI3), % time of sleep spent with oxygen saturation <90%, apnea-hypopnea index, asynchrony index
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Up to 6 months after starting NIV
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Modified Borg dyspnea score (see description)
大体时间：Up to 6 months after baseline
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The Modified Borg Dyspnea Scale is a 10-point Likert scale asking subjects to rate perceived shortness of breath, ranging from 0 (no breathlessness at all) to 10 (maximal breathlessness)
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Up to 6 months after baseline
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2008年2月1日
初级完成 (实际的)
2010年7月1日
研究完成 (实际的)
2010年7月1日
研究注册日期
首次提交
2011年3月28日
首先提交符合 QC 标准的
2011年5月31日
首次发布 (估计)
2011年6月2日
研究记录更新
最后更新发布 (实际的)
2020年11月13日
上次提交的符合 QC 标准的更新
2020年11月10日
最后验证
2020年11月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.
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