A Prospective Observational Study of Biopredictors of Bronchial Thermoplasty Response in Patients With Severe Refractory Asthma (BTR Study)
NCT ID: NCT01185275
Last Updated: 2020-11-27
Study Results
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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COMPLETED
133 participants
OBSERVATIONAL
2010-08-31
2019-10-01
Brief Summary
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Detailed Description
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Secondary Aims
1. To assess the relationship between baseline clinical, physiologic, biologic and imaging markers and response to bronchial thermoplasty, defined by reduction in severe exacerbations or healthcare utilization, in patients with severe refractory asthma.
2. To evaluate if baseline clinical, physiologic, biologic and imaging markers are related to safety of bronchial thermoplasty in patients with severe refractory asthma.
3. To evaluate and validate statistical models that predict response to bronchial thermoplasty in patients with severe refractory asthma.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Severe Asthma Patients
Severe asthma patients symptomatic despite high dose inhaled corticosteroid and long acting beta-agonist
Alair system
Bronchial thermoplasty
Interventions
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Alair system
Bronchial thermoplasty
Eligibility Criteria
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Inclusion Criteria
2. Subject has asthma and is taking regular maintenance medication for past 12 months that includes:
* Inhaled corticosteroid (ICS) at a dosage greater than 1000μg beclomethasone per day or equivalent, AND long acting ß2-agonist (LABA) at a dosage of ≥100μg per day Salmeterol or equivalent.
* Other asthma medications such as leukotriene modifiers, or anti-IgE, are acceptable (Subjects on Xolair® must have been on Xolair for greater than 1 year).
3. Asthma confirmed by: (a) b-agonist reversibility of FEV1 ≥ 12 % following 360mcg albuterol OR (b) methacholine FEV1 PC20 ≤ 8 mg/ml if not receiving an ICS or ≤ 16 mg/ml if receiving an ICS.
4. FEV1 ≥ 50% predicted pre-bronchodilator.
5. Asthma symptoms on at least two days or one night per week over the last 2 weeks.
6. Subject is a non-smoker for 1 year or greater (if former smoker, less than 10 pack years total smoking history).
7. Ability to undergo bronchoscopy in the opinion of the investigator.
8. Ability and willingness to provide informed consent.
Exclusion Criteria
2. Subject has 3 or more hospitalizations for exacerbations of asthma in the previous year or 1 or more ICU admission for asthma in the previous year.
3. Chronic oral steroid therapy greater than 30 mg per day
4. Subject has other respiratory diseases including interstitial lung disease, emphysema, cystic fibrosis, vocal cord dysfunction, mechanical upper airway obstruction, untreated obstructive sleep apnea, Churg-Strauss syndrome, cardiac dysfunction, and allergic bronchopulmonary aspergillosis (total IgE of \>1000 Units/mL with positive specific IgE to aspergillus and evidence of central bronchiectasis) that in the opinion of the investigator would prevent participation in the trial or put the participant at risk by participation.
5. Subject has segmental atelectasis, lobar consolidation, significant or unstable pulmonary infiltrate, or pneumothorax, confirmed on x-ray.
6. Subject has clinically significant cardiovascular disease, including myocardial infarction, angina, cardiac dysrhythmia, conduction defect, cardiomyopathy, aortic aneurysm, or stroke.
7. Subject has uncontrolled hypertension (\>200mm Hg systolic or \>100mm Hg diastolic pressure).
8. Subject uses an internal or external pacemaker or cardiac defibrillator.
9. Chronic diseases (other than asthma) that in the opinion of the investigator would prevent participation in the trial or put the participant at risk by participation, e.g. chronic diseases of the lung (other than asthma), heart, liver, kidney, or nervous system, or immunodeficiency
10. History of cigarette smoking with \> 10 pack years total
11. Use of investigative drugs or intervention trials in the 30 days prior to enrollment or during the duration of the study
12. Any condition or compliance issue which in the opinion of the investigator might interfere with participation in the study
18 Years
65 Years
ALL
No
Sponsors
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The Cleveland Clinic
OTHER
National Jewish Health
OTHER
University of Arizona
OTHER
University of Chicago
OTHER
Louisiana State University Health Sciences Center in New Orleans
OTHER
University of Alabama at Birmingham
OTHER
Creighton University
OTHER
Washington University School of Medicine
OTHER
Responsible Party
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Principal Investigators
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Mario Castro, MD, MPH
Role: PRINCIPAL_INVESTIGATOR
Washington University School of Medicine
Locations
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University of Alabama at Birmingham
Birmingham, Alabama, United States
University of Arizona
Tucson, Arizona, United States
National Jewish Health
Denver, Colorado, United States
University of Chicago
Chicago, Illinois, United States
Louisiana State University Health Sciences Center in New Orleans
New Orleans, Louisiana, United States
Washington University School of Medicine
St Louis, Missouri, United States
Creighton University
Omaha, Nebraska, United States
Cleveland Clinic
Cleveland, Ohio, United States
Countries
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References
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Samant M, Krings JG, Lew D, Goss CW, Koch T, McGregor MC, Boomer J, Hall CS, Schechtman KB, Sheshadri A, Peterson S, Erzurum S, DePew Z, Morrow LE, Hogarth DK, Tejedor R, Trevor J, Wechsler ME, Sam A, Shi X, Choi J, Castro M. Use of Quantitative CT Imaging to Identify Bronchial Thermoplasty Responders. Chest. 2024 Apr;165(4):775-784. doi: 10.1016/j.chest.2023.12.015. Epub 2023 Dec 18.
Other Identifiers
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10-0716- 201106118
Identifier Type: -
Identifier Source: org_study_id