Personalized Variable Versus Fixed Dose Glucocorticoid Therapy in AECOPD

NCT ID: NCT02147015

Last Updated: 2020-10-26

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

248 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-06-30

Study Completion Date

2018-04-30

Brief Summary

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The hypothesis is that in acute exacerbated Chronic Obstructive Pulmonary Disease (AECOPD), personalized variable dose glucocorticoid treatment will result in superior clinical outcome when compared to fixed dose therapy.

Detailed Description

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Treatment with glucocorticoid for acute exacerbations of COPD results in the improvement of clinical outcomes. However, the optimal doses of glucocorticoid for each individual patient has not been determined. According to GOLD Report 2014, a dose of 40 mg prednisone per day for 5 days is recommended (Evidence B), although there are insufficient data to provide firm conclusions concerning the optimal duration of corticosteroid therapy of acute exacerbations of COPD. The purpose of the current study is to compare clinical outcomes of personalized or fixed dose of glucocorticoid in patients with acute exacerbations of COPD.

Conditions

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Chronic Obstructive Pulmonary Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Personalized variable dose of glucocorticoids arm

Use of personalized variable dose of glucocorticoids according to a rating scale starting from the first day of hospitalization for 5 days, together with other necessary treatments, including antibiotics, Inhaled corticosteroid (ICS), long-acting beta2-agonist (LABA), Long-Acting Muscarinic Antagonists(LAMA), short-acting beta2-agonist (SABA), and other physical treatments.

Group Type EXPERIMENTAL

Glucocorticoids

Intervention Type DRUG

Antibiotics

Intervention Type DRUG

Inhaled corticosteroid (ICS)

Intervention Type DRUG

Long-Acting Muscarinic Antagonists(LAMA)

Intervention Type DRUG

Short-acting beta2-agonist (SABA)

Intervention Type DRUG

Physical treatments

Intervention Type OTHER

long-acting beta2-agonist (LABA)

Intervention Type DRUG

Fixed dose of glucocorticoids arm

Use of fixed term of glucocorticoids (40mg) starting from the first day of hospitalization for 5 days, together with other necessary treatments, including antibiotics, ICS, LABA, LAMA, SABA, and other physical treatments.

Group Type OTHER

Glucocorticoids

Intervention Type DRUG

Antibiotics

Intervention Type DRUG

Inhaled corticosteroid (ICS)

Intervention Type DRUG

Long-Acting Muscarinic Antagonists(LAMA)

Intervention Type DRUG

Short-acting beta2-agonist (SABA)

Intervention Type DRUG

Physical treatments

Intervention Type OTHER

long-acting beta2-agonist (LABA)

Intervention Type DRUG

Interventions

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Glucocorticoids

Intervention Type DRUG

Antibiotics

Intervention Type DRUG

Inhaled corticosteroid (ICS)

Intervention Type DRUG

Long-Acting Muscarinic Antagonists(LAMA)

Intervention Type DRUG

Short-acting beta2-agonist (SABA)

Intervention Type DRUG

Physical treatments

Intervention Type OTHER

long-acting beta2-agonist (LABA)

Intervention Type DRUG

Other Intervention Names

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methylprednisolone

Eligibility Criteria

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Inclusion Criteria

* Exacerbation of COPD as defined by the presence of at least 2 of the following: change in baseline dyspnea, cough, or sputum quantity or purulence.

Exclusion Criteria

* Signs of severe exacerbation (arterial pH \< 7.26 or PaCO2 \> 9.3 kPa)
* History of asthma
* Significant or unstable co-morbidity
* Participated in another study 4 weeks before admission
* Previously randomized to this study
* Known hypersensitivity to prednisolone
* Inability to give written informed consent
* Radiological diagnosis of pneumonia
* Estimated survival of less than 6 months due to severe comorbidity
* Use of glucocorticoid within 1 month before admission
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Daping Hospital and the Research Institute of Surgery of the Third Military Medical University

OTHER

Sponsor Role lead

Responsible Party

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Guoqiang Cao,MD

Vice Chair of Department of Respiratory Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Guoqiang Cao, Medical Doctor

Role: PRINCIPAL_INVESTIGATOR

Daping Hospital, Third Military Medical University

Locations

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Daping Hospital

Chongqing, Chongqing Municipality, China

Site Status

Countries

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China

References

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Davies L, Angus RM, Calverley PM. Oral corticosteroids in patients admitted to hospital with exacerbations of chronic obstructive pulmonary disease: a prospective randomised controlled trial. Lancet. 1999 Aug 7;354(9177):456-60. doi: 10.1016/s0140-6736(98)11326-0.

Reference Type BACKGROUND
PMID: 10465169 (View on PubMed)

Lindenauer PK, Pekow PS, Lahti MC, Lee Y, Benjamin EM, Rothberg MB. Association of corticosteroid dose and route of administration with risk of treatment failure in acute exacerbation of chronic obstructive pulmonary disease. JAMA. 2010 Jun 16;303(23):2359-67. doi: 10.1001/jama.2010.796.

Reference Type BACKGROUND
PMID: 20551406 (View on PubMed)

Leuppi JD, Schuetz P, Bingisser R, Bodmer M, Briel M, Drescher T, Duerring U, Henzen C, Leibbrandt Y, Maier S, Miedinger D, Muller B, Scherr A, Schindler C, Stoeckli R, Viatte S, von Garnier C, Tamm M, Rutishauser J. Short-term vs conventional glucocorticoid therapy in acute exacerbations of chronic obstructive pulmonary disease: the REDUCE randomized clinical trial. JAMA. 2013 Jun 5;309(21):2223-31. doi: 10.1001/jama.2013.5023.

Reference Type BACKGROUND
PMID: 23695200 (View on PubMed)

Li L, Zhao N, Ma X, Sun F, He B, Qin Z, Wu K, Wang X, Zhao Q, Zhang S, Nie N, Luo D, Sun B, Shen Y, He Y, Wen F, Zheng J, Jones P, Cao G. Personalized Variable vs Fixed-Dose Systemic Corticosteroid Therapy in Hospitalized Patients With Acute Exacerbations of COPD: A Prospective, Multicenter, Randomized, Open-Label Clinical Trial. Chest. 2021 Nov;160(5):1660-1669. doi: 10.1016/j.chest.2021.05.024. Epub 2021 May 21.

Reference Type DERIVED
PMID: 34023318 (View on PubMed)

Other Identifiers

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VIP

Identifier Type: -

Identifier Source: org_study_id