Interaction in Chronic Obstructive Pulmonary Disease Experiment

NCT ID: NCT00981851

Last Updated: 2011-07-06

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

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-09-30

Study Completion Date

2011-05-31

Brief Summary

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The final purpose of this study is to determine whether bronchodilation and cigarette smoking in Chronic Obstructive Pulmonary Disease (COPD) patients interact, resulting in an increase of cardiovascular disease. The aim of this part of the study is to demonstrate the basic mechanism: Does increased respiratory function after administration of a bronchodilator in patients with COPD lead to elevated pulmonary retention of the harmful compounds in inhaled cigarette smoke and to short-term biological effects associated with cardiovascular disease?

Detailed Description

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COPD currently is one of the most frequent diseases. In more than 80% of COPD patients, the disease is caused by smoking. About half of the COPD patients are active smokers, although smoking is also the most important prognostic factor. Also, smoking is an important cause as well as an important prognostic factor in cardiovascular disease. The corner stone of medical treatment in COPD is bronchodilation; more than half of the patients use a long-acting bronchodilator. An increase of the pathogenic effect of smoking by an increased lung function after bronchodilation is likely though, since more pathogenic particles would penetrate the lung. We hypothesize that bronchodilators increase cardiovascular disease in COPD patients who smoke.

In order to demonstrate the basic mechanism of our hypothesis, COPD patients receive a bronchodilator at one time and a placebo at another time, preceded and followed by cigarette smoking during one hour as by a strict time schedule. Smoke retention, lung function and blood biomarkers are repeatedly measured.

Conditions

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Chronic Obstructive Pulmonary Disease Cardiovascular Disease Smoking Bronchodilation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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beta 2 agonist + anticholinergic aerosol

Group Type ACTIVE_COMPARATOR

Tiotropium (Spiriva) + Salbutamol (Ventolin)

Intervention Type DRUG

1 time inhalation of 5 mcg of Tiotropium bromide by Respimat and 400 mcg of Salbutamol by Volume Spacer. cigarette smoking

placebo inhalation

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

1 time inhalation of placebo with the amount of puffs similar to the active comparator. cigarette smoking

Interventions

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Tiotropium (Spiriva) + Salbutamol (Ventolin)

1 time inhalation of 5 mcg of Tiotropium bromide by Respimat and 400 mcg of Salbutamol by Volume Spacer. cigarette smoking

Intervention Type DRUG

placebo

1 time inhalation of placebo with the amount of puffs similar to the active comparator. cigarette smoking

Intervention Type DRUG

Other Intervention Names

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Spiriva Respimat Ventolin Aerosol Ventolin placebo and Spiriva placebo

Eligibility Criteria

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Inclusion Criteria

* COPD Gold stage II-III (FEV1/FVC\<0,70 and FEV1 30-80% of predicted value).
* Current cigarette smoking (at the time of performing the study).
* Willing to provide written informed consent.
* Refrain from smoking and bronchodilators \> 8 hours (depends on treatment) before the test.
* Registered in one of the recruitment institutes.

Exclusion Criteria

* COPD gold stage I or IV.
* Asthmatic component: History of asthma, present asthma by complaints, eosinophilia or reversibility ≥ 10% of predicted.
* Unable to communicate.
* Physically unable to perform any of the tests.
* Non-COPD respiratory disorders.
* Previous lung-volume reduction surgery and/or lung transplantation.
* Evidence of alcohol, drug or solvent abuse.
* Known α-1 antitrypsin deficiency.
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Radboud University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Radboud University Nijmegen Medical Center

Principal Investigators

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Tjard RJ Schermer, PhD

Role: PRINCIPAL_INVESTIGATOR

Radboud University Nijmegen Medical Center

Locations

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University Center for Chronic Diseases Dekkerswald

Groesbeek, , Netherlands

Site Status

Primary care, general practitioners

Nijmegen, , Netherlands

Site Status

Countries

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Netherlands

References

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van Dijk WD, Heijdra Y, Lenders JW, Klerx W, Akkermans R, van der Pouw A, van Weel C, Scheepers PT, Schermer TR. Cigarette smoke retention and bronchodilation in patients with COPD. A controlled randomized trial. Respir Med. 2013 Jan;107(1):112-9. doi: 10.1016/j.rmed.2012.09.019. Epub 2012 Oct 12.

Reference Type DERIVED
PMID: 23069326 (View on PubMed)

van Dijk WD, Scheepers PT, Cremers R, Lenders JW, Klerx W, van Weel C, Schermer TR, Heijdra Y. A method to study the effect of bronchodilators on smoke retention in COPD patients: study protocol for a randomized controlled trial. Trials. 2011 Feb 10;12:37. doi: 10.1186/1745-6215-12-37.

Reference Type DERIVED
PMID: 21310040 (View on PubMed)

Other Identifiers

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RvB08.066.51196/GE

Identifier Type: -

Identifier Source: org_study_id

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