Bronchodilators and Respiratory Mechanics in Chronic Obstructive Pulmonary Disease (COPD) Patients
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Purpose
The aim of this study is to assess the effects on respiratory mechanics of one "classical" short-term bronchodilator (i.e., salbutamol) versus placebo, and to verify the hypothesis that the addition of another bronchodilator (i.e., anticholinergic) may induce a further improvement on the work of breathing of stable COPD patients.
| Condition | Intervention | Phase |
|---|---|---|
|
Chronic Obstructive Pulmonary Disease |
Drug: Salbutamol + Tiotropium Drug: Placebo + Tiotropium |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Effect of Bronchodilators on Respiratory Mechanics in COPD Patients With Poor Reversibility |
- Recordings of respiratory mechanics [ Time Frame: 90 minutes ] [ Designated as safety issue: No ]
- Dyspnea score [ Time Frame: 90 minutes ] [ Designated as safety issue: No ]
| Enrollment: | 20 |
| Study Start Date: | September 2008 |
| Study Completion Date: | July 2012 |
| Primary Completion Date: | August 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Salbutamol+Tiotropium
Salbutamol will be given at the dose of 400 micrograms and Tiotropium at the dose of 18 micrograms
|
Drug: Salbutamol + Tiotropium
Salbutamol 400 micrograms + Tiotropium 18 micrograms
Other Names:
|
|
Placebo Comparator: placebo + Tiotropium
Placebo using MDI + administration of Tiotropium after 20 minutes
|
Drug: Placebo + Tiotropium
Placebo via MDI + Tiotropium 18 micrograms
Other Name: Spiriva
|
Detailed Description:
Studies with long-acting b2-agonists in COPD patients who poorly respond to routine airways obstruction reversibility tests with forced expiratory manoeuvres, such as forced expiratory volume in one second (FEV1), are scarce. Such studies, however, seem to show favourable effects on clinical parameters.
This may explain the subjective improvements and changes in quality of life with long-acting b2-agonists in patients with COPD. The lack of effect on forced expiration tests may be due to early airway collapse and subsequent airflow decline causing underestimation of the existing bronchodilatory effects located more peripherally in the respiratory tract, where the major site of resistance is located in obstructive lung disease.
We therefore design a study aimed to assess the short term effects of one short-acting beta2-agonist vs placebo, and the effects of an additional and sequential administration of a different bronchodilator, like tiotropium bromide (anticholinergic agent) on the work of breathing, and its components (i.e., lung resistances and compliance) of COPD patients with poor reversibility assessed using the classical Pulmonary Function Tests.
Eligibility| Ages Eligible for Study: | 20 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- COPD patient with a Tiffenau ratio <55% and >25% predicted
- Poor reversibility to an acute bronchodilator test (i.e. FEV1 changes<10% from baseline)
Exclusion Criteria:
- Lack of informed consent
- Cancer
- Concomitant lung and airways diseases
Contacts and Locations
More Information
No publications provided
| Responsible Party: | dr. Stefano Nava, Chief ICU, Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi |
| ClinicalTrials.gov Identifier: | NCT00783250 History of Changes |
| Other Study ID Numbers: | 350 |
| Study First Received: | October 30, 2008 |
| Last Updated: | July 16, 2012 |
| Health Authority: | Italy: National Monitoring Centre for Clinical Trials - Ministry of Health |
Keywords provided by Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi:
|
COPD Respiratory Mechanics Bronchodilators COPD patients with poor reversibility |
Additional relevant MeSH terms:
|
Lung Diseases Respiration Disorders Pulmonary Disease, Chronic Obstructive Lung Diseases, Obstructive Respiratory Tract Diseases Albuterol Bronchodilator Agents Tiotropium Tocolytic Agents Reproductive Control Agents Physiological Effects of Drugs Pharmacologic Actions Therapeutic Uses |
Adrenergic beta-2 Receptor Agonists Adrenergic beta-Agonists Adrenergic Agonists Adrenergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Autonomic Agents Peripheral Nervous System Agents Anti-Asthmatic Agents Respiratory System Agents Parasympatholytics Cholinergic Antagonists Cholinergic Agents |
ClinicalTrials.gov processed this record on May 16, 2013