Dyspnea in COPD: Relationship With Exacerbations Frequency

NCT ID: NCT02113839

Last Updated: 2015-08-20

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

34 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-30

Study Completion Date

2015-05-31

Brief Summary

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The perception of breathlessness varies significantly among COPD patients with similar severity of airflow limitation; those with poorer perception report less exacerbations as compared to those with frequent exacerbations.

Cross-sectional comparison of breathlessness perception in COPD patients with frequent exacerbations or without frequent exacerbations.

To assess "Breathlessness Perception" the investigators will increase the ventilatory demand of the patients by CO2-rebreathing method.

Detailed Description

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The perception of breathlessness varies between individuals. This is a well-established concept in asthma, but mostly unexplored in COPD; the relationship between airflow limitation (FEV1, % ref.) and breathlessness (mMRC) is weak.

The perception of breathlessness varies significantly among COPD patients with similar severity of airflow limitation; those with poorer perception report less exacerbations as compared to those with frequent exacerbations.

It is a cross-sectional comparison of breathlessness perception in COPD patients with frequent exacerbations (≥2 or ≥1 with hospitalization in the previous year) or without frequent exacerbations (0 or 1 without hospitalization in the previous year).

To assess "Breathlessness Perception" the investigators will increase the ventilatory demand of the patients by CO2-rebreathing method. CO2 rebreathing test will be conducted to evaluate the acute ventilatory response to CO2 inhalation used to estimate central chemoreceptor responsiveness in patients with the obstructive pulmonary disease.

Simple descriptive statistics (unpaired T-test) and correlation analysis (bivariate and multivariate) will be used to analyze results.

Conditions

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Dyspnea

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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No frequent exacerbators

Patients without exacerbations: 0 or 1 that did not required hospitalization in the previous year.

Interventions:

* Spirometry
* Emogas analysis
* Modified Borg Dyspnea Scale
* CO Exhaled breath
* P01
* FeNO

Group Type ACTIVE_COMPARATOR

Spirometry

Intervention Type PROCEDURE

Before re-breathing (if the patient not performed one 6 months in advance).

CO Exhaled breath

Intervention Type PROCEDURE

In current smokers of both arms to confirm that the patient has not smoked in the past three hours and to asses the smoking status (heavy, moderate, light).

P01

Intervention Type PROCEDURE

P01 is the negative airway pressure generated during the first 100 ms of an occluded inspiration. It's an estimation of the neuromuscular drive to breathe.

FeNO

Intervention Type PROCEDURE

The measurement of fraction of exhaled nitric oxide during exacerbations of COPD is higher than normal.

Frequent exacerbators

Patients with frequent exacerbations: ≥2 or ≥1 if it required hospitalization in the previous year.

Interventions:

* Spirometry
* Emogas analysis
* Modified Borg Dyspnea Scale
* CO Exhaled breath
* P01
* FeNO

Group Type ACTIVE_COMPARATOR

Spirometry

Intervention Type PROCEDURE

Before re-breathing (if the patient not performed one 6 months in advance).

CO Exhaled breath

Intervention Type PROCEDURE

In current smokers of both arms to confirm that the patient has not smoked in the past three hours and to asses the smoking status (heavy, moderate, light).

P01

Intervention Type PROCEDURE

P01 is the negative airway pressure generated during the first 100 ms of an occluded inspiration. It's an estimation of the neuromuscular drive to breathe.

FeNO

Intervention Type PROCEDURE

The measurement of fraction of exhaled nitric oxide during exacerbations of COPD is higher than normal.

Interventions

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Spirometry

Before re-breathing (if the patient not performed one 6 months in advance).

Intervention Type PROCEDURE

CO Exhaled breath

In current smokers of both arms to confirm that the patient has not smoked in the past three hours and to asses the smoking status (heavy, moderate, light).

Intervention Type PROCEDURE

P01

P01 is the negative airway pressure generated during the first 100 ms of an occluded inspiration. It's an estimation of the neuromuscular drive to breathe.

Intervention Type PROCEDURE

FeNO

The measurement of fraction of exhaled nitric oxide during exacerbations of COPD is higher than normal.

Intervention Type PROCEDURE

Other Intervention Names

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FEV1 FVC FEV1/FVC VC TLC Rwc DLCO DLCO/VA Ventilation (VE) Inspiratory capacity (IC) CO (ppm) COHb (%)

Eligibility Criteria

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Inclusion Criteria

* patients with diagnosis of COPD (Gold 2 or 3 or 4)
* \>2 months from last exacerbation and no change in therapy

Exclusion Criteria

* patients on regular sedative drugs
* patients with neuromuscular diseases
* patients with respiratory failure and/or in long-term oxygen therapy
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Clinic of Barcelona

OTHER

Sponsor Role lead

Responsible Party

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Isabel Blanco

MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Isabel Blanco Vich, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Clínic

Alvar G Agustí, MD, PhD

Role: STUDY_DIRECTOR

Hospital Clínic

Locations

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Hospital Clínic

Barcelona, BCN, Spain

Site Status

Countries

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Spain

References

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Reference Type BACKGROUND
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Miravitlles M, Anzueto A, Legnani D, Forstmeier L, Fargel M. Patient's perception of exacerbations of COPD--the PERCEIVE study. Respir Med. 2007 Mar;101(3):453-60. doi: 10.1016/j.rmed.2006.07.010. Epub 2006 Aug 30.

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Reference Type BACKGROUND
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Rodriguez-Roisin R. Toward a consensus definition for COPD exacerbations. Chest. 2000 May;117(5 Suppl 2):398S-401S. doi: 10.1378/chest.117.5_suppl_2.398s.

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Jones PW, Nadeau G, Small M, Adamek L. Characteristics of a COPD population categorised using the GOLD framework by health status and exacerbations. Respir Med. 2014 Jan;108(1):129-35. doi: 10.1016/j.rmed.2013.08.015. Epub 2013 Aug 30.

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Agusti AG, Villaverde JM, Togores B, Bosch M. Serial measurements of exhaled nitric oxide during exacerbations of chronic obstructive pulmonary disease. Eur Respir J. 1999 Sep;14(3):523-8. doi: 10.1034/j.1399-3003.1999.14c08.x.

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Parker J, Wolansky LJ, Khatry D, Geba GP, Molfino NA. Brain magnetic resonance imaging in adults with asthma. Contemp Clin Trials. 2011 Jan;32(1):86-9. doi: 10.1016/j.cct.2010.09.006. Epub 2010 Sep 18.

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Reference Type BACKGROUND
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Scioscia G, Blanco I, Arismendi E, Burgos F, Gistau C, Foschino Barbaro MP, Celli B, O'Donnell DE, Agusti A. Different dyspnoea perception in COPD patients with frequent and infrequent exacerbations. Thorax. 2017 Feb;72(2):117-121. doi: 10.1136/thoraxjnl-2016-208332. Epub 2016 Sep 1.

Reference Type DERIVED
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Other Identifiers

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DysPerEx

Identifier Type: -

Identifier Source: org_study_id

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