Economic Evaluation of Treatment Modalities for Position Dependent Obstructive Sleep Apnea

NCT ID: NCT02553902

Last Updated: 2018-04-11

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

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-09-30

Study Completion Date

2019-12-31

Brief Summary

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OBJECTIVES:

To evaluate the effect and cost-utility of a combination therapy of SPT+MAD compared with continuous positive airway pressure (CPAP) in patients with moderate positional obstructive sleep apnea (POSA).

HYPOTHESIS:

The SPT+MAD combination is more cost-effective and effective, in means of reduction of the apnea-hypopnea index (AHI), quality of life and compliance, compared with CPAP.

STUDY DESIGN:

A multicenter randomized clinical trial (RCT) will be performed with a follow-up of 12 months per patient. Patients will be randomized for CPAP or the combination SPT and MRA. All outcomes will be measured at baseline, month 3, 6 and 12.

STUDY POPULATION:

Patients diagnosed with moderate POSA according to polysomnography (PSG) results.

INTERVENTION / STANDARD INTERVENTION TO BE COMPARED TO:

The SPT trains POSA patients to sleep in non-supine positions, CPAP uses positive airway pressure to open the airway; MRA is an intra-oral prosthesis, which holds the mandible in a protrusive position, all to prevent effectively apneic events.

OUTCOME MEASURES:

AHI, compliance, quality-adjusted life year (QALY), direct and indirect costs, cardiovascular parameters, incremental cost-effectiveness ratio (ICER)

SAMPLE SIZE / DATA ANALYSIS:

100 subjects in each treatment group, total of 200 patients.

COST-EFFECTIVENESS ANALYSIS / BUDGET IMPACT ANALYSIS:

The SPT is expected to improve the cost-effectiveness of overall treatment of POSA patients, and will save annually approximately 35-150 million euros.

Detailed Description

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Conditions

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Positional Obstructive Sleep Apnea

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Combination therapy

Sleep Position Trainer + Mandibular Advancement device combination The SPT is a sensor that measures the sleeping position, and gives the user feedback about wrong positions with a soft vibration. A user is then able to react to the signal and turn into a non-supine position. To stimulate compliance, information is provided about nightly behaviour, implicating a learning pattern by viewing the data on a home computer.

MRA or oral appliances (OA) works by advancing the mandible and its attached soft tissue structures forward they aim to increase upper airway size.

Group Type ACTIVE_COMPARATOR

Sleep position trainer

Intervention Type DEVICE

Mandibular advancement device

Intervention Type DEVICE

CPAPContinuous positive airway pressure

Continuous positive airway pressure (CPAP) functions as a pneumatic splint to maintain upper airway patency. Possible side effect can be related to the interface, pressure and negative social factors.

Group Type ACTIVE_COMPARATOR

Continuous positive airway pressure

Intervention Type DEVICE

Interventions

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Sleep position trainer

Intervention Type DEVICE

Mandibular advancement device

Intervention Type DEVICE

Continuous positive airway pressure

Intervention Type DEVICE

Other Intervention Names

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MRA, MAD

Eligibility Criteria

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Inclusion Criteria

* 18 years and older
* Ability to speak, read and write Dutch
* Ability to follow up
* Diagnosis with symptomatic moderate OSA (15 \< AHI \< 30)
* Diagnosis of 10 to 90% supine position during the night
* AHI supine is 2 \> as high as AHI non-supine
* Own a Windows PC and ability to install SPT connection software and upload research data
* Expected to maintain current lifestyle (sports, medicine, diet etc.)

Exclusion Criteria

* Many dental problems; insufficient teeth for wearing MRA
* Medication used/ related to sleeping disorders
* Central Sleep Apnea Syndrome
* Night or shifting work
* Severe chronic heart failure
* Medical history of known causes of tiredness by day or severe sleep disruption (insomnia, PLMS, Narcolepsy)
* Seizure disorder
* Known medical history of mental retardation, memory disorders or psychiatric disorders
* Shoulder, neck and back complaints
* Reversible morphological upper airway abnormalities (e.g. enlarged tonsils)
* Inability to provide informed consent
* Simultaneous use of other treatment modalities to treat OSA
* Previous treatment for OSA with MRA, CPAP or SPT
* Pregnancy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Antwerp

OTHER

Sponsor Role collaborator

Onze Lieve Vrouwe Gasthuis

OTHER

Sponsor Role lead

Responsible Party

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L.B.L. Benoist

Drs.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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O.M. Vanderveken, Professor

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Antwerp

Locations

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Antwerp University Hospital (UZA)

Antwerp, , Belgium

Site Status RECRUITING

OLVG West

Amsterdam, , Netherlands

Site Status RECRUITING

Countries

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Belgium Netherlands

Central Contacts

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Patty Vonk, MD

Role: CONTACT

N de Vries, Professor

Role: CONTACT

Facility Contacts

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O.M. Vanderveken, Professor

Role: primary

N. de Vries, Professor

Role: primary

Patty Vonk, MD

Role: backup

Other Identifiers

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NL52032.029.15

Identifier Type: -

Identifier Source: org_study_id

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