Benefit of High-flow Nasal Cannula on Persistent Dyspnea in Ild

NCT ID: NCT06617078

Last Updated: 2024-09-27

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-15

Study Completion Date

2026-10-15

Brief Summary

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The main purpose of this study is to evaluate the effects of high-flow nasal therapy (HFNT) oxygen compared to long-term oxygen therapy (LTOT) on dyspnea and quality of life in intersititial lung disease patients with chronic respiratory failure and persistent breathlessness in whom LTOT has already been initiated.

Detailed Description

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The study will be a non-blinded, two-arm, crossover (2 periods of 2 weeks each), randomised controlled superiority multicentre trial comparing the effect of HFNT on persistent dyspnoea in intersititial lung disease patients with chronic respiratory failure as compared to LTOT over a two-week period. The oxygen flow rate with HFNT will be the same as for usual care. The HFNT will be used during the night and during the 3-minute chair rise test, it can be used during the day depending on the patient's needs. During the rest of the time, the LTOT will be used as in usual care. Participants will be randomised to receive (1) 2 weeks of LTOT then 2 weeks of LTOT+HFNT or (2) 2 weeks of LTOT+HFNT then 2 weeks of LTOT. The investigators will determine the effect of HFNT on quality of life and dyspnoea. The investigators will also study the effect of HFNT on secondary outcomes listed below. Each assessment will be performed at the end of each 2-week period. Polysomnography will be optional. The study will be conducted in 42 patients with LTOT suffering from persistent breathlessness.

With a total sample of 38 patients and a crossover design, if the real difference on the Saint George's Respiratory Questionnaire (SGRQ) is 6, the standard deviation of the matched difference is 12.5 and the significance threshold is 5%, a two-tailed Student's t test will have a power of 80% to conclude that the difference is significantly different from 0 (Calculated using PASS 14.0.14, Analysis of a cross-over design using difference).These hypotheses are based on the values observed in the article by Nagata et al. (PMID: 29283682), in patients with Chronic Obstructive Pulmonary Diseaes of the same severity, which reported an improvement in the SGRQ-s of -10.8 (95% CI: -15.3; -6.3, i.e. SD of 12.4) with HFNT administered at night for 6 weeks versus LTOT Another study (PMID: 31308647) reported an improvement of -11.9 (CI95% -17.2; -6.6) after an introduction of HFNT. As the minicmal clinical improvement difference for SGRQ is 4, a difference of 6 is considered was both realistic and clinically relevant. A Student's t test allows a conservative approach compared to the use of a linear mixed-effects model retained for the analysis of the primary endpoint.

To take account of reduced precision due to possible loss of follow-up or study withdrawals, the sample was increased by 10%, i.e. 42 patients: 21 in the HFNT+LTOT then LTOT sequence and 21 in the LTOT then HFNT+LTOT sequence.

Conditions

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ILD

Keywords

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Chronic breathlessness ILD high nasal flow canula

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Long-Term Oxygen therapy (LTOT) then High Flow Nasal Therapy (HFNT)

2 weeks of LTOT then 2 weeks of LTOT+HFNT

Group Type OTHER

long-term oxygen therapy (LTOT)

Intervention Type PROCEDURE

Usual care with LTOT for 2 weeks

High Flow Nasal Therapy (HFNT)

Intervention Type PROCEDURE

High Flow Nasal delivered by myAirvo3 (4 hours minimum and during th 3-minute chair rise test, 30L/min, 34°C, identical O2 flow rate as LTOT) for 2 weeks

High Flow Nasal Therapy (HFNT) then Long-Term Oxygen therapy (LTOT)

2 weeks of LTOT+HFNT then 2 weeks of LTOT

Group Type OTHER

long-term oxygen therapy (LTOT)

Intervention Type PROCEDURE

Usual care with LTOT for 2 weeks

High Flow Nasal Therapy (HFNT)

Intervention Type PROCEDURE

High Flow Nasal delivered by myAirvo3 (4 hours minimum and during th 3-minute chair rise test, 30L/min, 34°C, identical O2 flow rate as LTOT) for 2 weeks

Interventions

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long-term oxygen therapy (LTOT)

Usual care with LTOT for 2 weeks

Intervention Type PROCEDURE

High Flow Nasal Therapy (HFNT)

High Flow Nasal delivered by myAirvo3 (4 hours minimum and during th 3-minute chair rise test, 30L/min, 34°C, identical O2 flow rate as LTOT) for 2 weeks

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Intertitial lung disease
* Persistant dyspnea (mMRC≥3)
* Long-term oxygen therapy at least for 3 months

Exclusion Criteria

* Chronic respiratory disease (COPD, lung cancer)
* Pneumothorax,
* Pneumomediastinum,
* Active smoker,
* Patient on non-invasive ventilation or continuous positive airway pressure (CPAP),
* Pregnancy or breastfeeding,
* Unable to read or understand questionnaires,
* No written consent,
* Patients under guardianship,
* No health assurance coverage
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Capucine Morélot-Panzini, MD,PhD, Prof

Role: PRINCIPAL_INVESTIGATOR

APHP • Assistance Publique des hôpitaux de Paris

Central Contacts

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Capucine Morélot-Panzini, MD,PhD, Prof

Role: CONTACT

Phone: 0142167771

Email: [email protected]

Anne Radenne

Role: CONTACT

Phone: 0142161699

Email: [email protected]

Other Identifiers

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IDRCB

Identifier Type: OTHER

Identifier Source: secondary_id

APHP210079

Identifier Type: -

Identifier Source: org_study_id