Comparison of Corticosteroids vs Placebo on Duration of Ventilatory Support During Severe Acute Exacerbations of COPD Patients in the ICU

NCT ID: NCT04163536

Last Updated: 2023-10-18

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

440 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-25

Study Completion Date

2026-03-01

Brief Summary

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The main objective of this study is to determine if the systemic (intravenous) administration of corticosteroids, as compared to placebo, increases the number of ventilator-free days (VFD) and alive at day 28 in COPD patients admitted to an ICU, a step-up unit or a respiratory care unit for an ACRF requiring ventilatory support, either invasive or non-invasive.

Detailed Description

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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

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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cortisteroids arm

Group Type ACTIVE_COMPARATOR

Methylprednisolone

Intervention Type DRUG

In the experimental group, methylprednisolone will be administered intravenously for 5 days at a dose of 1 mg/kg/day. Methylprednisolone will be provided for reconstitution and dilution in 50 ml of NaCl 0.9% solution and administered over 15 minutes, once a day.

placebo arm

Group Type PLACEBO_COMPARATOR

Placebos

Intervention Type DRUG

in the control group, placebo will be administered intravenously for 5 days. Placebo will be identical (color and aspect) to experimental substance, will be provide as a 50 mL of NaCl 0.9% solution and administered intravenously over 15 minutes, once a day.

Interventions

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Methylprednisolone

In the experimental group, methylprednisolone will be administered intravenously for 5 days at a dose of 1 mg/kg/day. Methylprednisolone will be provided for reconstitution and dilution in 50 ml of NaCl 0.9% solution and administered over 15 minutes, once a day.

Intervention Type DRUG

Placebos

in the control group, placebo will be administered intravenously for 5 days. Placebo will be identical (color and aspect) to experimental substance, will be provide as a 50 mL of NaCl 0.9% solution and administered intravenously over 15 minutes, once a day.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Patients aged ≥ 40 years
2. Strongly suspected or documented COPD, defined by the presence of the following criterias:

* Persistent respiratory symptoms (dyspnoea, chronic cough or sputum)
* History of exposure to a risk factor such as tobacco smoke
* If available, pulmonary function tests showing airflow limitation not fully reversible (post-bronchodilator ratio of FEV1/ FVC ratio \< 0.7)
3. ACRF, defined by the presence of the two following criteria:

* COPD exacerbation defined by a change in the patient baseline respiratory symptoms at least 24 hours and requiring a change in regular respiratory medication
* Acute respiratory failure \<24h (polypnea ≥ 30 breaths.min-1 or use of accessory respiratory muscles) requiring ventilatory support, either invasive (implemented because of respiratory distress) or NIV (implemented because of hypercapnic acidosis with PaCO2 ≥ 45 mmHg and pH ≤ 7.35).
4. Admission to an ICU, a step-up unit or a respiratory care unit
5. Inform consent from the patient or his surrogates. In patients who are not able to consent on admission an emergency inclusion procedure will be allowed, with a mandatory delayed consent.
6. Affiliation to (or benefit from) French health insurance system

Exclusion Criteria

* Previous diagnostic of asthma, according to "GINA" international guidelines (40)
* Recent use of systemic corticosteroids, defined by systemic corticosteroids use in the past 7 days
* Contra-indication of systemic corticosteroids treatment: allergy to corticosteroids, uncontrolled severe arterial hypertension, uncontrolled diabetes mellitus, gastro-intestinal ulcer bleeding
* Pneumothorax at randomization
* Extracorporeal life support (ECMO or ECCO2R) at inclusion
* Moribund patient life expectancy \< 3 months
* Pregnancy
* Patients protected by law
* Exclusion period due to other interventional clinical trial enrolment which can influence primary outcome
* Previous inclusion in the present study
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Versailles Hospital

OTHER

Sponsor Role lead

Responsible Party

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Alexis FERRE

coordinating investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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André Mignot Hospital, Intensive care unit

Le Chesnay, Les Yvelines, France

Site Status RECRUITING

CHU Angers

Angers, , France

Site Status RECRUITING

CH métropole savoie

Chambéry, , France

Site Status NOT_YET_RECRUITING

CHU Louis Mourier

Colombes, , France

Site Status RECRUITING

CHU Henri mondor

Créteil, , France

Site Status NOT_YET_RECRUITING

CHU Dijon

Dijon, , France

Site Status RECRUITING

CHU Grenoble

Grenoble, , France

Site Status RECRUITING

CHD Vendée

La Roche-sur-Yon, , France

Site Status RECRUITING

CHU de Bicêtre

Le Kremlin-Bicêtre, , France

Site Status RECRUITING

CH Le Mans

Le Mans, , France

Site Status RECRUITING

CHRU lille

Lille, , France

Site Status RECRUITING

CHU Lyon

Lyon, , France

Site Status RECRUITING

CH d'Annecy Genevois

Metz-Tessy, , France

Site Status RECRUITING

CHU Nantes

Nantes, , France

Site Status NOT_YET_RECRUITING

CHR orléans

Orléans, , France

Site Status RECRUITING

CHU Cochin

Paris, , France

Site Status RECRUITING

Hôpital européen Georges pompidou

Paris, , France

Site Status RECRUITING

Pitié-Salpêtrière

Paris, , France

Site Status RECRUITING

CHU Poitiers

Poitiers, , France

Site Status RECRUITING

CHU de Rennes

Rennes, , France

Site Status RECRUITING

CHU de Rouen

Rouen, , France

Site Status NOT_YET_RECRUITING

Hopital Foch

Suresnes, , France

Site Status ACTIVE_NOT_RECRUITING

CHRU Tours

Tours, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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virginie chatagner

Role: CONTACT

0139239776

Other Identifiers

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P17/15_corticop

Identifier Type: -

Identifier Source: org_study_id

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