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Effects of Acute Long-acting Bronchodilation on Oxygenation and Peripheral Ventilation in COPD

Phase 3
Completed
Conditions
Pulmonary Disease, Chronic Obstructive
Interventions
Drug: LABA
Registration Number
NCT05927155
Lead Sponsor
Erasme University Hospital
Brief Summary

The goal of this clinical trial was to compare the action of long-acting ß2-agonists (LABA-olodaterol) and muscarinic antagonists (LAMA-tiotropium) on tissue oxygenation in COPD considering their impact on proximal and peripheral ventilation and, eventually, on lung capillary volume. The hypothesis was that LABA would have a more peripheral effect than LAMA (due to the opposite gradient of their receptors) and better peripheral ventilation would result in a greater oxygenation.

Before and after LABA (visit 1) and LAMA (visit 2) inhalation, COPD participants were asked to perform single-breath washout and forced oscillation tests, double diffusion technique and spirometry, while transcutaneous oxygenation was continuously recorded.

Detailed Description

Slopes of He (SHe) and SF6 (SSF6) from single-breath washout test (SBWO) (assessing ventilation heterogeneities at the level of pre- and intra-acinar bronchioles, respectively) (quadruple model, LR6000 Logan-Sinclair, Rochester, UK), respiratory system resistance (R5, R5-R19) and reactance (X5, AX, Fres) from forced oscillation test (FOT) (Resmon Pro, ResTech, Italy), lung capillary volume (Vc) from double diffusion of NO and CO (DLNO/DLCO) (Hyp'Air compact, Medisoft, Dinant, Belgium), and FEV1 from spirometry (Zan®, Oberthulba, Germany) were evaluated before and after LABD administered via a spacer device: during the first visit, before, 30 minutes and 2 hours after inhalation of 4 puffs of 2,5 µg of olodaterol (LABA); during the second visit, before, 40 minutes and 2 hours after the administration of 4 puffs of 2,5 µg of tiotropium (LAMA). Transcutaneous oximetry (Perimed232©, Järfälla, Sweden) was monitored continuously during the 2 hours of each visit.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria
  • COPD diagnosis according to international criteria
Exclusion Criteria
  • inability to perform the tests or to maintain the washout period
  • an exacerbation within the previous 6 weeks
  • a diagnosis of asthma or another chronic respiratory disease that could influence the results of the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
LABA (olodaterol)LABAAfter 4-5 days washout period, during the first visit, participants received a long-acting beta2-agonist (LABA)
LAMA (tiotropium)LAMATwo days after the first visit, during the second visit , participants received a long-acting muscarinic antagonist (LAMA)
Primary Outcome Measures
NameTimeMethod
Tissue oxygenation (TcO2) change from baseline30 (LABA)/40 (LAMA) minutes post-drug administration

Transcutaneous oxygen (TcO2) evaluated continuously with a transcutaneous oximeter

Secondary Outcome Measures
NameTimeMethod
Resonant frequency (Fres) change from baseline30 (LABA)/40 (LAMA) minutes post-drug administration

Fres from forced oscillation test (FOT) also evaluating the peripheral lung function

Peripheral resistance (R5-R19) change from baseline30 (LABA)/40 (LAMA) minutes post-drug administration

Peripheral resistance, assessed as frequency dependence of resistance (R5-R19) from forced oscillation test (FOT) also evaluating the peripheral lung function

Lung capillary volume (Vc) change from baseline30 (LABA)/40 (LAMA) minutes post-drug administration

Vc from single-breath double diffusion technique of nitric oxide (NO) and carbon monoxide (CO) (DLNO/DLCO)

Slope of Helium (SHe) change from baseline30 (LABA)/40 (LAMA) minutes post-drug administration

SHe from single-breath washout test (SBWO) assessing peripheral ventilation heterogeneities

Area under reactance curve from 5 Hz (AX) change from baseline30 (LABA)/40 (LAMA) minutes post-drug administration

AX from forced oscillation test (FOT) evaluating the peripheral lung function

Reactance at 5 Hz (X5) change from baseline30 (LABA)/40 (LAMA) minutes post-drug administration

X5 from forced oscillation test (FOT) also evaluating the peripheral lung function

Forced Expiratory Volume in 1 Second (FEV1) change from baseline30 (LABA)/40 (LAMA) minutes post-drug administration

FEV1 from spirometry

Trial Locations

Locations (1)

Erasme University Hospital

🇧🇪

Brussels, Belgium

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