Dual Anti-platelet Therapy in Chronic Obstructive Pulmonary Disease Study
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 15
- 试验地点
- 2
- 主要终点
- Pulmonary microvascular blood volume, CV
研究概览
简要总结
This is a 6 week crossover study in current and former smokers with and without COPD to evaluate whether 2 weeks of dual antiplatelet therapy (aspirin 81mg and clopidogrel 75mg) improves pulmonary perfusion (i.e. blood flow in the lungs measured on a contrast CT scan) compared to placebo.
详细描述
This is a single-center Phase IIa randomized double-blind crossover study in smokers with and without chronic obstructive pulmonary disease (COPD) to test whether dual antiplatelet therapy (aspirin 81mg and clopidogrel 75mg) improves pulmonary perfusion (i.e. blood flow in the lungs) compared to placebo.
We will enroll 30 subjects (20 with COPD, 10 without) who will each take part for 6 weeks. Participants and researchers will be blinded, they will not know which medications they are on first. Each participant will be asked to take aspirin and clopidogrel together for 2 weeks and also matching placebos for 2 weeks, with a 2 week washout period in between. Pulmonary blood flow will be evaluated with a contrast-enhanced CT scan of the chest two times over the 6 week study.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Other
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
盲法说明
All participants, investigators and care providers will be blinded as to dual-anti platelet therapy or placebo treatment
入排标准
- 年龄范围
- 50 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •COPD Cases:
- •COPD (FEV1/FVC < 0.7, FVC >= LLN), GOLD Stage I/II/III (FEV1 >= 40%)
- •Current or former smoker of at least 10 pack years
- •Inclusion Criteria - Controls:
- •Normal lung function (FEV1/FVC >= 0.7, FEV1 and FVC >= LLN)
- •Current or former smoker of at least 10 pack years
排除标准
- •Platelet count < 150,000/dL or self-report of a bleeding disorder;
- •Regular use of aspirin, clopidogrel or another antiplatelet medication;
- •Allergy to aspirin, clopidogrel, albuterol or iodine/IV contrast;
- •BMI > 35;
- •History of intracranial hemorrhage, severe GI bleed or other life-threatening bleed;
- •Use of blood thinner (e.g. warfarin, lovenox or novel oral anti-coagulants);
- •Continuous use of supplemental oxygen at home;
- •Regular use of an NSAID;
- •Daily use of oral steroids, theophylline, roflumilast, or loop diuretics;
- •History of organ transplant or autoimmune disease on systemic therapy (rheumatoid arthritis, lupus);
- •Use of a biologic medication with regular injections;
- •Other current lung disease (interstitial lung disease, idiopathic pulmonary fibrosis, asthma);
- •IV drug use within the last year;
- •History of lung surgery to remove part of the lung;
- •Known bullae or advanced destructive emphysema in more than 1/3 of the lungs;
- •Treatment for cancer (systemic therapy or surgical/radiation within the thorax) in the last 12 months;
- •Known diagnosis of pulmonary hypertension;
- •Known systolic heart failure (RV or LV EF < 40%);
- •Acute or chronic renal insufficiency (estimated glomerular filtration rate [GFR] <60 mL/min/1.73 m2 or self-report). GFR will be calculated using the CKD-EPI equation;
- •Current or planned pregnancy in the next year;
- •Regular marijuana smoking;
- •Exacerbation of respiratory symptoms within the previous 6 weeks, such as that requiring hospitalization, oral prednisone or antibiotics to control symptoms, or longer and not yet returned to baseline; and
- •Chest, abdominal or eye surgery, or a heart attack or stroke, within the last 3 months.
研究组 & 干预措施
COPD Cases: Dual antiplatelet therapy first, then placebo
Dual antiplatelet therapy (aspirin 81mg and clopidogrel 75mg) will be given for 2 weeks, followed by 2 weeks without intervention, then 2 weeks of placebo
干预措施: Placebo (Drug)
COPD Cases: Dual antiplatelet therapy first, then placebo
Dual antiplatelet therapy (aspirin 81mg and clopidogrel 75mg) will be given for 2 weeks, followed by 2 weeks without intervention, then 2 weeks of placebo
干预措施: dual anti-platelet therapy (Combination Product)
COPD Cases: Placebo first, then dual antiplatelet therapy
Placebos for each therapy (2 pills) will be given for 2 weeks, followed by 2 weeks without intervention, then 2 weeks of dual antiplatelet therapy
干预措施: dual anti-platelet therapy (Combination Product)
COPD Cases: Placebo first, then dual antiplatelet therapy
Placebos for each therapy (2 pills) will be given for 2 weeks, followed by 2 weeks without intervention, then 2 weeks of dual antiplatelet therapy
干预措施: Placebo (Drug)
Controls: Dual antiplatelet therapy first, then placebo
Dual antiplatelet therapy (aspirin 81mg and clopidogrel 75mg) will be given for 2 weeks, followed by 2 weeks without intervention, then 2 weeks of placebo
干预措施: dual anti-platelet therapy (Combination Product)
Controls: Dual antiplatelet therapy first, then placebo
Dual antiplatelet therapy (aspirin 81mg and clopidogrel 75mg) will be given for 2 weeks, followed by 2 weeks without intervention, then 2 weeks of placebo
干预措施: Placebo (Drug)
Controls: Placebo first, then dual antiplatelet therapy
Placebos for each therapy (2 pills) will be given for 2 weeks, followed by 2 weeks without intervention, then 2 weeks of dual antiplatelet therapy
干预措施: dual anti-platelet therapy (Combination Product)
Controls: Placebo first, then dual antiplatelet therapy
Placebos for each therapy (2 pills) will be given for 2 weeks, followed by 2 weeks without intervention, then 2 weeks of dual antiplatelet therapy
干预措施: Placebo (Drug)
结局指标
主要结局
Pulmonary microvascular blood volume, CV
时间窗: 6 weeks
Coefficient of variation (CV) of pulmonary microvascular blood volume on dual energy CT scan, comparing on dual antiplatelet therapy to placebo
Pulmonary Microvascular Blood Volume, CV
时间窗: After 2 weeks of therapy
Coefficient of variation (CV) of pulmonary microvascular blood volume on dual energy CT scan, comparing on dual antiplatelet therapy to placebo
次要结局
- Pulmonary microvascular blood volume(6 weeks)
- Oxygen saturation(6 weeks)
- Pulmonary Microvascular Blood Volume(After 2 weeks of therapy)
- Oxygen Saturation(After 2 weeks of therapy)
研究者
Carrie Pistenmaa, M.D
Assistant Professor
Brigham and Women's Hospital