Predictor for an Additional Benefit of Inhaled Corticosteroid in Patients Treated With Tiotropium for Chronic Obstructive Pulmonary Disease (COPD)
Overview
- Phase
- Phase 4
- Intervention
- Budesonide
- Conditions
- COPD
- Sponsor
- Cantonal Hosptal, Baselland
- Enrollment
- 90
- Locations
- 1
- Primary Endpoint
- Change in Lung Function (FEV1)
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
Study purpose is to evaluate if subjects with chronic obstructive pulmonary disease (COPD) are more likely to be responsive to additional inhaled corticosteroids if they have a positive response to hyperosmolar challenge with mannitol than if their response is negative.
Detailed Description
In patients with chronic obstructive pulmonary disease (COPD), the treatment with inhaled corticosteroids (ICS) is controversial. Preliminary results of our recent pilot study in 30 COPD patients showed for the first time, that ICS response mey be predicted by a bronchoprovocation challenge test with mannitol. However, this finding needs to be proven in a placebo-controlled trial. For this cohort study, 100 corticosteroid-naive, non reversible (FEV1) patients with COPD will be recruited. Spirometry before and after bronchodilation will be measured at study entry and at four weeks run-in (only tiotropium) and at three month of treatment with tiotropium and ICS or placebo. Quality of life (St. George Respiratory Quality of Life Questionnaire) and exacerbation rate of COPD will be assessed. Measurement of exhaled nitric oxide and mannitol challenge will be performed at study entry and at 1 and 4 month. Primary endpoint will be improvement in FEV1 in each group (positive and negative mannitol challenge) after 3 months follow up. Secondary endpoints will be the difference in dose-response-curve in the mannitol challenge, exacerbation rate and change in quality of life after three month follow-up.
Investigators
Prof. Dr. Jörg Leuppi
Prof. Dr.
Cantonal Hosptal, Baselland
Eligibility Criteria
Inclusion Criteria
- •FEV1/FVC \< 70%
- •FEV1 % predicted \> 60%
Exclusion Criteria
- •Other major disease
- •Currently taking inhaled corticosteroids
- •oral corticosteroids in the last 3 month
- •significant cardiovascular disease
- •pregnancy/breast feeding
- •current use of salmeterol or other long acting bronchodilator
Arms & Interventions
Budesonide
Intervention: Budesonide
Placebo
Intervention: Budesonide
Outcomes
Primary Outcomes
Change in Lung Function (FEV1)
Time Frame: 12 weeks
Secondary Outcomes
- The Proportion Who Complete Follow-up Without Developing an Exacerbation(12 weeks)
- Change in logRDR Mannitol(12 weeks)
- Change in Quality of Life(12 weeks, baseline to 3 months follow-up)