Thoracic Kyphosis and Osteoporosis: Study of Their Relationship With Respiratory Functions in Chronic Obstructive Pulmonary Disease.

NCT ID: NCT04757714

Last Updated: 2024-01-10

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

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2023-06-30

Study Completion Date

2025-06-30

Brief Summary

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Chronic Obstructive Pulmonary Disease (COPD) is a condition characterized by a progressive and incompletely reversible limitation of airborne gas flow . The association of co-morbidities with COPD and acute flare-ups of respiratory failure contribute to the overall severity of this disease. The prevalence of COPD is high, affecting up to 10% of people over the age of 40 years and causing high morbidity and mortality rates. While COPD is a disease primarily affecting the lungs, it is associated with many extra-pulmonary conditions including sleep apnea, depression, anemia, chronic kidney failure, wasting, cardiovascular disease, skeletal muscle weakness and osteoporosis (OP).

Detailed Description

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Osteoporosis, characterized by bone quality disorders and low bone mineral density (BMD) leading to a high risk of fractures, is common in COPD patients. For example, studies have reported OP rates ranging from 9% to 69% in COPD patients. The explanatory factors for this low BMD are clearly multiple, involving to varying degrees of importance, vitamin D deficiency, depression, sedentary lifestyle, smoking, corticosteroids, low lean body mass and body mass index, chronic inflammation, low nutritional status, chronic hypoxia and hypercapnia. This is why patients with COPD have a high prevalence of fractures, particularly vertebral fractures (VF) ranging from 30 to 63% depending on the studies. In these patients the existence of thoracic VF is of crucial importance, as each VF is associated with a 9% decrease in the forced vital capacity of COPD patients.

For these reasons the latest HAS recommendations for COPD management indicate that the risk of osteoporosis should be systematically investigated and treated (HAS, 2014).

However, the relationship between densitometric variations and the presence of thoracic VF and the prognosis and severity of the disease is not yet very clear, as studies of these relationships have produced mixed results.

On the other hand, it is well established that patients with a recent diagnosis of COPD have a high prevalence of densitometric OPs and fractures.

Thoracic kyphosis is one of the determinants of the incidence of vertebral fractures. Increased thoracic kyphosis is associated with decreased physical capacity, increased risk of falls and abnormal respiratory function.

In addition, measurement of thoracic kyphosis was previously carried out either indirectly using point coordinates recorded in a database (patients were assessed in the supine position) or more directly using a ruler applied against the back.

Conditions

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COPD Osteoporosis Kyphosis

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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COPD Patients

Patients agreeing to participate in the study and meeting the inclusion and non-inclusion criteria will have:

* The high-resolution peripheral scanner (HRpQCT) of the tibia and radius
* a low-dose imaging system exploration of their thoraco-lumbar spine (EOS system)
* to complete:

* a physical activity questionnaire (PHAS instrument)
* a COPD quality of life questionnaire (St George Hospital)
* A search for sarcopenia by studying the strength of the grip (dynamometer)

Group Type OTHER

The high-resolution peripheral scanner (HRpQCT) of the tibia and radius

Intervention Type PROCEDURE

The high-resolution peripheral scanner (HRpQCT) of the tibia and radius

a low-dose imaging system exploration of their thoraco-lumbar spine (EOS system)

Intervention Type PROCEDURE

a low-dose imaging system exploration of their thoraco-lumbar spine (EOS system)

Questionnaires

Intervention Type OTHER

* a physical activity questionnaire (PHAS instrument)
* a COPD quality of life questionnaire (St George Hospital)

A search for sarcopenia by studying the strength of the grip (dynamometer)

Intervention Type OTHER

A search for sarcopenia by studying the strength of the grip (dynamometer)

Interventions

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The high-resolution peripheral scanner (HRpQCT) of the tibia and radius

The high-resolution peripheral scanner (HRpQCT) of the tibia and radius

Intervention Type PROCEDURE

a low-dose imaging system exploration of their thoraco-lumbar spine (EOS system)

a low-dose imaging system exploration of their thoraco-lumbar spine (EOS system)

Intervention Type PROCEDURE

Questionnaires

* a physical activity questionnaire (PHAS instrument)
* a COPD quality of life questionnaire (St George Hospital)

Intervention Type OTHER

A search for sarcopenia by studying the strength of the grip (dynamometer)

A search for sarcopenia by studying the strength of the grip (dynamometer)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Man or woman age \> 40
* FEV1/CVF ratio \< 0.7 as defined by the Global Initiative for Chronic Obstruction Lung Disease (GOLD).
* Moderate to severe COPD as defined by GOLD (grade C and D)

Exclusion Criteria

* Presence of metal or plastic parts in the field of examination
* Pregnancy
* Patients who are not affiliated with or do not benefit from a social security system
* Person under guardianship or curatorship
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Hospitalier Régional d'Orléans

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Eric LESPESSSAILLES, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

CHR ORLEANS

Locations

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CHR d'ORLEANS

Orléans, , France

Site Status

Countries

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France

References

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Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, Pinto Plata V, Cabral HJ. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004 Mar 4;350(10):1005-12. doi: 10.1056/NEJMoa021322.

Reference Type BACKGROUND
PMID: 14999112 (View on PubMed)

Cielen N, Maes K, Gayan-Ramirez G. Musculoskeletal disorders in chronic obstructive pulmonary disease. Biomed Res Int. 2014;2014:965764. doi: 10.1155/2014/965764. Epub 2014 Mar 25.

Reference Type BACKGROUND
PMID: 24783225 (View on PubMed)

Decramer M, Janssens W, Miravitlles M. Chronic obstructive pulmonary disease. Lancet. 2012 Apr 7;379(9823):1341-51. doi: 10.1016/S0140-6736(11)60968-9. Epub 2012 Feb 6.

Reference Type BACKGROUND
PMID: 22314182 (View on PubMed)

Eagan TM, Aukrust P, Ueland T, Hardie JA, Johannessen A, Mollnes TE, Damas JK, Bakke PS, Wagner PD. Body composition and plasma levels of inflammatory biomarkers in COPD. Eur Respir J. 2010 Nov;36(5):1027-33. doi: 10.1183/09031936.00194209. Epub 2010 Apr 22.

Reference Type BACKGROUND
PMID: 20413541 (View on PubMed)

Ekblom O, Ekblom-Bak E, Bolam KA, Ekblom B, Schmidt C, Soderberg S, Bergstrom G, Borjesson M. Concurrent and predictive validity of physical activity measurement items commonly used in clinical settings--data from SCAPIS pilot study. BMC Public Health. 2015 Sep 28;15:978. doi: 10.1186/s12889-015-2316-y.

Reference Type BACKGROUND
PMID: 26415512 (View on PubMed)

Other Identifiers

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CHRO-2020-05

Identifier Type: -

Identifier Source: org_study_id

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