The Effect of Hypertonic Saline on the Lung Clearance Index in Patients With Cystic Fibrosis
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Purpose
This study is examining the effect of hypertonic saline compared to placebo on the Lung Clearance Index in Cystic Fibrosis patients.
| Condition | Intervention | Phase |
|---|---|---|
|
Cystic Fibrosis |
Drug: hypertonic saline (7 %) and isotonic saline (0.9%) |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Caregiver, Investigator) Primary Purpose: Treatment |
| Official Title: | The Effect of Inhaled Hypertonic Saline (7%) Versus Normal Saline (0.9%) on the Lung Clearance Index in Patients With Cystic Fibrosis |
- Change in LCI from baseline to end of treatment in hypertonic saline treated patients versus patients receiving placebo (isotonic saline) [ Time Frame: Duration of patient's involvement in study ] [ Designated as safety issue: No ]
- Change in FEV1 % predicted [ Time Frame: Duration of patient's involvement in study ] [ Designated as safety issue: No ]
- Change in FVC (forced vital capacity) % predicted [ Time Frame: Duration of patient's involvement in study ] [ Designated as safety issue: No ]
- Change in FEF25-75% (forced expiratory flow between 25 and 75 % of vital capacity) predicted [ Time Frame: Duration of patient's involvement in study ] [ Designated as safety issue: No ]
| Enrollment: | 20 |
| Study Start Date: | March 2008 |
| Study Completion Date: | December 2008 |
| Primary Completion Date: | December 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: 1 |
Drug: hypertonic saline (7 %) and isotonic saline (0.9%)
Patients in study arm 1 will receive hypertonic saline (7 %) during the first phase of the study and will crossover to placebo (0.9% isotonic saline) during the second phase. Both drugs will be administered via PARI LC® Star reusable nebulizer.
|
| Experimental: 2 |
Drug: hypertonic saline (7 %) and isotonic saline (0.9%)
Patients in study arm 2 will receive placebo (0.9% isotonic saline) during the first phase of the study and will crossover to hypertonic saline (7 %) during the second phase. Both drugs will be administered via PARI LC® Star reusable nebulizer.
|
Detailed Description:
The life expectancy of patients with Cystic Fibrosis (CF) has greatly increased over time due to improved clinical care. While this is certainly beneficial to CF patients, the overall stability in lung function has made it more difficult to assess the effect of therapeutic interventions. Currently, FEV1 (forced expiratory volume in 1 second) remains the primary outcome measure for most clinical trials, but many CF patients have normal pulmonary function and the annual rate of decline is now less than 2% in large specialized centres. Therefore, additional parameters are needed that are more sensitive parameters to define abnormalities in CF patients and be used in therapeutic trials.
One such promising parameter is the Lung Clearance Index (LCI). The LCI is a test to quantify ventilation inhomogeneity by assessing the washout of an inhaled inert gas. Abnormalities in gas clearance from the lung are largely due to retention of inhaled gases due to mucous obstruction in the lower airways.
Interventions that improve mucus accumulation are expected to improve the LCI. Hypertonic saline has been shown to increase airway surface liquid (ASL), mucociliary clearance and pulmonary function. Therefore, this study will examine the effect of hypertonic saline compared to placebo on the Lung Clearance Index in Cystic Fibrosis patients.
Eligibility| Ages Eligible for Study: | 6 Years to 18 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Diagnosis of CF as defined by two or more clinical features of CF and a documented sweat chloride > 60 mEq/L by quantitative pilocarpine iontophoresis test or a genotype showing two well characterized disease causing mutations
- Informed consent and verbal assent (as appropriate) provided by the subject's parent or legal guardian and the subject
- 6-18 years of age at enrolment and able to perform reproducible spirometry
- Clinically stable at enrolment
- FEV1 % predicted ≥ 80 % as calculated by the Wang reference equations
- Ability to comply with medication use, study visits and study procedures
Exclusion Criteria:
- Respiratory culture positive for NTM or B. cepacia complex within past year or screening
- Use of intravenous antibiotics or oral quinolones within 14 days of screening
- Investigational drug use within 30 days of screening
- Physical findings at screening that would compromise the safety of the participant or the quality of the study data
Contacts and Locations| Canada, Ontario | |
| The Hospital for Sick Children | |
| Toronto, Ontario, Canada | |
| Principal Investigator: | Felix Ratjen, MD | The Hospital for Sick Children |
More Information
Publications:
| Responsible Party: | The Hospital for Sick Children |
| ClinicalTrials.gov Identifier: | NCT00635141 History of Changes |
| Other Study ID Numbers: | 1000011193 |
| Study First Received: | March 4, 2008 |
| Last Updated: | February 22, 2012 |
| Health Authority: | Canada: Health Canada |
Keywords provided by The Hospital for Sick Children:
|
Cystic Fibrosis Lung Clearance Index Hypertonic Saline Pediatrics |
Additional relevant MeSH terms:
|
Cystic Fibrosis Fibrosis Pancreatic Diseases Digestive System Diseases Lung Diseases |
Respiratory Tract Diseases Genetic Diseases, Inborn Infant, Newborn, Diseases Pathologic Processes |
ClinicalTrials.gov processed this record on June 18, 2013