MxA and CRP-Guided Use of Antimicrobial Agents for AECOPD

NCT ID: NCT06779344

Last Updated: 2025-01-16

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

458 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-01-13

Study Completion Date

2026-12-31

Brief Summary

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This randomized controlled trial will investigate the clinical impact of Myxovirus Resistance A (MxA) and C-Reactive Protein (CRP)-guided antimicrobial treatment compared to usual care in outpatients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).

Detailed Description

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Respiratory viral infections are a leading cause of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). However, there is currently a lack of rapid diagnostic methods to differentiate the cause of AECOPD, resulting in insufficient attention to viral-induced exacerbations, with antibiotic treatment remaining the primary treatment.

Myxovirus resistance protein A (MxA) has been identified as a potential biomarker to distinguish respiratory viral infections, while C-reactive protein (CRP) has been confirmed as a useful guide for antibiotic therapy in AECOPD.

This randomized controlled trial aims to investigate the clinical value of MxA and CRP-guided antimicrobial treatment in outpatients with AECOPD, with the goal of reducing antibiotic overuse and improving patient outcomes.

Conditions

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Acute Exacerbation Chronic Obstructive Pulmonary Disease

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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MxA and CRP-guided group

Perform MxA and CRP test; Report MxA and CRP results to attending clinicians; Provide MxA and CRP-based guidelines for antimicrobial treatment to the attending clinicians; Conduct follow-up telephone visits on Day 14, Day 30, and Day 90

Group Type EXPERIMENTAL

MxA and CRP tests

Intervention Type OTHER

A whole blood sample will be collected on the day of randomization for MxA and CRP testing.

MxA and CRP feedback

Intervention Type OTHER

MxA and CRP results will be reported to the attending physcian within 4 hours, along with antimicrobial treatment guidelines based on these results.

Follow up

Intervention Type OTHER

Telephone visit will be conducted on Day 14, Day 30, and Day 90 after randomization.

Day 14 and Day 30 follow-up: antimicrobial usage; additional medical visits, hospitalization, death, symptom scores (CAT score and mMRC score).

Day 90 follow-up: Occurrence of another exacerbation of COPD, symptom scores (CAT score and mMRC score), death.

Usual-care group

Conduct follow-up telephone visits on Day 14, Day 30, and Day 90.

Group Type ACTIVE_COMPARATOR

Follow up

Intervention Type OTHER

Telephone visit will be conducted on Day 14, Day 30, and Day 90 after randomization.

Day 14 and Day 30 follow-up: antimicrobial usage; additional medical visits, hospitalization, death, symptom scores (CAT score and mMRC score).

Day 90 follow-up: Occurrence of another exacerbation of COPD, symptom scores (CAT score and mMRC score), death.

Interventions

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MxA and CRP tests

A whole blood sample will be collected on the day of randomization for MxA and CRP testing.

Intervention Type OTHER

MxA and CRP feedback

MxA and CRP results will be reported to the attending physcian within 4 hours, along with antimicrobial treatment guidelines based on these results.

Intervention Type OTHER

Follow up

Telephone visit will be conducted on Day 14, Day 30, and Day 90 after randomization.

Day 14 and Day 30 follow-up: antimicrobial usage; additional medical visits, hospitalization, death, symptom scores (CAT score and mMRC score).

Day 90 follow-up: Occurrence of another exacerbation of COPD, symptom scores (CAT score and mMRC score), death.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* ≥40 years old;
* Current or former smoker with a minimum smoking history of 10 pack years, clinical diagnosed with mild-to-severe COPD;
* Presenting with an acute exacerbation of COPD
* The severity of AECOPD is mild to moderate.

Exclusion Criteria

* Required urgent hospitalization
* Received interferon therapy within 30 days before screening
* Had an active systemic inflammatory condition within 30 days prior to screening, such as cerebral infarction, myocardial infarction, or surgery
* Received vaccine in the past 30 days
* Active tuberculosis
* Immunocompromised
* Presenting with current respiratory failure
* Clinical suspicion of pneumonia or pulmonary edema.
* Coexisting bronchiectasis, cystic fibrosis, or asthma
* Had a concurrent infection at another site, such as urinary tract infections or sinusitis;
* Contraindications to antibiotics and/or antivirals
* Known etiology of the present exacerbation
* Pre-treatment with corticosteroids (cumulative dose of methylprednisolone ≥ 80 mg or equivalent dose) for the present exacerbation.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Capital Medical University

OTHER

Sponsor Role lead

Responsible Party

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Bin Cao

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bin Cao

Role: STUDY_DIRECTOR

China-Japan Friendship Hospital

Locations

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China-Japan Friendship hospital

Beijing, Beijing Municipality, China

Site Status

Countries

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China

Central Contacts

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Yeming Wang, M.D.

Role: CONTACT

+86 84206264

Mengwei Yan, M.D.

Role: CONTACT

Facility Contacts

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Bin Cao

Role: primary

01084206264

Other Identifiers

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CAP-China AECOPD-bundle

Identifier Type: -

Identifier Source: org_study_id

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