Effectiveness of Nebulised Hypertonic Saline to Decrease Respiratory Exacerbations in People With Neuromuscular Disease or Neurodisability: a Phase 2 Open Label Pilot Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 40
- 试验地点
- 4
- 主要终点
- Course of antibiotics for respiratory infections
研究概览
简要总结
Research Aim: This study investigates whether a 12-month treatment with hypertonic saline (salty water) can reduce antibiotic use in individuals with neuromuscular disease or cerebral palsy who frequently experience chest infections due to difficulty clearing mucus from their airways.
Methodology: Participants will be randomly assigned to receive nebulised hypertonic saline (7% salt in water) or normal saline (0.9% salt in water). The study is open-label as both participants and researchers are aware of the treatment, necessary due to the differing tastes of the solutions. Two centers, Royal Brompton Hospital in London and Queens Medical Centre in Nottingham, will conduct the research.
Before starting the treatment, participants will undergo various assessments, including questionnaires to measure quality of life and treatment satisfaction, sputum/throat swab collection, lung clearance index, forced oscillation technique, electrical impedance tomography, and lung ultrasound. Once these assessments are completed, participants will take the assigned treatment at home, administered twice daily for 12 months, with monthly follow-ups regarding difficulties and chest infections. After 12 months, the treatment will cease, and participants will repeat the assessments.
Significance: This research will provide valuable insights into the efficacy of nebulised hypertonic saline for individuals with neuromuscular disease or cerebral palsy, potentially aiding both patients and doctors in making informed treatment decisions.
Dissemination: The study's findings will be shared through publication in scientific journals and presentation at conferences.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 5 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosis of NMD or neurodisablity by a physician independent of the study, on standard criteria.
- •Age 5 years and above, including adults.
- •Must be able to tolerate nebulised 6% hypertonic saline.
- •Must have a history of at least one respiratory exacerbation requiring antibiotic treatment with or without the need for hospitalisation in the 12 months prior to recruitment.
排除标准
- •Patients with additional diagnosis, for example, CF, but those with aspiration and/or bronchiectasis secondary to respiratory complications of NMD will be included.
- •Patients who are already prescribed daily HS in any concentration (i.e, 3%, 5%, 6%, 7%) will be excluded, but those who are on daily NS or have HS prescribed as part of their escalation plan (i.e., PRN) will be included.
结局指标
主要结局
Course of antibiotics for respiratory infections
时间窗: from baseline to week 52
Full courses of antibiotics as prescribed for respiratory infections, both oral and intravenous, (excluding prophylactic antibiotic prescriptions). 1 course of antibiotic would be the full treatment for one event of respiratory infection, irrespective of the number of days that the course was prescribed for.
次要结局
- Lung clearance index(at baseline before and within 2 hours after drug response assessment, and at week 52.)
- Ease of airway clearance(Once monthly for 52 weeks.)
- Health economics(baseline, week 26 and week 51.)
- Airway inflammation(baseline and at week 52)
- Patient and main carer treatment satisfaction(weeks 12, 26, 39 and 51)
- Family impact(Baseline and at week 51.)
- Electrical Impedance Tomography(at baseline before and within 2 hours after drug response assessment, and at week 52.)
- Health-related quality of life(At baseline and at week 51.)
- Bacterial diversity(baseline and at week 52)
- Lung ultrasound(at baseline before and within 2 hours after drug response assessment, and at week 52.)
- Forced oscillation technique(at baseline before and within 2 hours after drug response assessment, and at week 52.)