The Prevalence and Significance of Gastro-oesophageal Reflux in Cystic Fibrosis Before and After Lung Transplantation

NCT ID: NCT00164021

Last Updated: 2016-01-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

180 participants

Study Classification

OBSERVATIONAL

Study Start Date

2001-02-28

Brief Summary

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Gastro-oesophageal reflux (GOR) has been found to be prevalent in children with cystic fibrosis (CF)and may further worsen lung damage via reflex bronchospasm or pulmonary aspiration. Chest physiotherapy may result in increased episodes of GOR as demonstrated in children. Lung transplantation may worsen pre-existing GOR. This study will determine the prevalence, severity and significance of symptomatic and silent GOR in adults with CF before and after lung transplant using 24hr oesophageal pH monitoring, a valid symptom questionnaire, quality of life questionnaires and gastric emptying studies. This study will identify the extent of GOR in a large adult CF population and the impact on lung function and quality of life together with the effects of medical and physiotherapy treatment on gastro-oesophageal function.

Detailed Description

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A factorial longitudinal study will be undertaken in adults with cystic fibrosis. Results will be compared with age matched healthy controls. It is not deemed appropriate to randomise patients with gastro-oesophageal reflux(GOR) to a treatment versus no treatment group as immediate treatment for GOR once diagnosed is regarded as obligatory.

Subjects: 180 adults with CF will be recruited from the Adult Cystic Fibrosis Unit at the Alfred Hospital to participate in the study. The ambulatory studies will be undertaken during baseline state in the outpatient setting. Fifteen age matched control subjects will be recruited from the general population.

Subjects who give their consent for participation in the study will undertake the following outcome measures:

1. Demographic data including age, gender, BMI, prescribed medication at the time of the study, lung function tests including FEV1, FVC, FEV1/FVC ratio and MMEF, genotype, pH of saliva and sputum.
2. Structured symptom questionnaire using a reliable valid measure developed by Carlsson et al 1998 will be used to assess patient's symptom scores.
3. Dual-channel 24hour oesophageal pH monitoring will be undertaken using a digitrapper (Medtronic, Sweden)and dual antimony tipped probe (Synectics, Sweden). Following calibration of the probes the distal antimony tip is positioned 5cm above the upper border of the lower oesophageal sphincter and the proximal probe 15 cm above the distal probe in the upper oesophagus.The patient will be instructed in using the three event buttons on the digitrapper recording start and finish time of meals, upright versus supine positioning and reflux episodes. The subject will be provided with a detailed 24hr 'Activity Diary' to record all meals (including percutaneous gastrostomy feeds), positions and activities including usual chest physiotherapy and physical exercise.The recorded pH information is downloaded into a computer program for analysis. The following indices will be measured in the distal and proximal oesophagus:

* Number of reflux episodes
* Fraction of reflux time
* Number of reflux episodes with duration longer than 5 minutes
* Duration of longest episodes in minutes
* DeMeester score (an overall weighted score of gastro-oesophageal function).
4. Quality of life questionnaires: SF36, Quittner CF Questionnaire (CFQ), Dietary and Bowel Symptom Questionnaires.
5. Chest radiographs

Conditions

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Cystic Fibrosis

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Cystic Fibrosis

Patients with cystic fibrosis

Physiotherapy, exercise, percutaneous gastrostomy feeds

Intervention Type PROCEDURE

Anti-reflux pharmacotherapy

Intervention Type DRUG

Control

No interventions assigned to this group

Interventions

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Physiotherapy, exercise, percutaneous gastrostomy feeds

Intervention Type PROCEDURE

Anti-reflux pharmacotherapy

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* \* Diagnosis of cystic fibrosis

* Medically stable

Exclusion Criteria

* \* Known oesophageal varices
Minimum Eligible Age

16 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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The Alfred

OTHER

Sponsor Role collaborator

Monash University

OTHER

Sponsor Role collaborator

Bayside Health

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Brenda M Button, DPhty, PhD

Role: PRINCIPAL_INVESTIGATOR

The Alfred

Susannah King

Role: PRINCIPAL_INVESTIGATOR

The Alfred

Colleen Ash

Role: PRINCIPAL_INVESTIGATOR

The Alfred

John W Wilson, MBBS, PhD

Role: PRINCIPAL_INVESTIGATOR

The Alfred

Greg Snell, MBBS

Role: PRINCIPAL_INVESTIGATOR

The Alfred

Stuart Roberts, MBBS

Role: PRINCIPAL_INVESTIGATOR

The Alfred

Locations

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The Alfred Hospital

Melbourne, Victoria, Australia

Site Status RECRUITING

Countries

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Australia

Central Contacts

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Brenda M. Button, DPhty, PhD

Role: CONTACT

9276 2000 ext. 3450

Facility Contacts

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Brenda M Button, DPhty, PhD

Role: primary

9276 2000 ext. 3450

John W Wilson, MBBS, PhD

Role: backup

9276 2000 ext. 3600

Other Identifiers

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Alfred Hospital $20,000 grant

Identifier Type: -

Identifier Source: secondary_id

1/01

Identifier Type: -

Identifier Source: org_study_id

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