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Noninvasive Ventilation in ALS Patients With Mild Respiratory Involvement

This study has been completed.
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by:
Johns Hopkins University Identifier:
First received: October 10, 2006
Last updated: November 8, 2007
Last verified: April 2007

Non-invasive ventilation or BiPAP®, which is a form of breathing support delivered through a facemask, is a successful treatment for the respiratory complications of amyotrophic lateral sclerosis (ALS). It has been shown to prolong survival, improve quality of life, and improve cognitive function. It is widely used among patients with ALS who have advanced breathing difficulties. It is not known whether there is benefit to using non-invasive ventilation earlier in the disease course.

There is evidence that non-invasive ventilation may slow down the decline in breathing function. If this were true then it would make sense to start non-invasive ventilation use earlier than the current clinically accepted practices.

The purpose of this study is to determine whether using non-invasive ventilation early in the course of disease can slow the decline in breathing function.

Patients remain in the study for 6 months and are asked to make 7 clinic visits during which time they will undergo pulmonary function tests and complete questionnaires.

Condition Intervention Phase
Amyotrophic Lateral Sclerosis Device: noninvasive positive pressure ventilation Phase 2 Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)
Primary Purpose: Supportive Care
Official Title: Noninvasive Ventilation in ALS Patients With Mild Respiratory Involvement

Resource links provided by NLM:

Further study details as provided by Johns Hopkins University:

Primary Outcome Measures:
  • Decline in forced vital capacity

Secondary Outcome Measures:
  • quality of life
  • respiratory quality of life

Estimated Enrollment: 60
Study Start Date: April 2002
Study Completion Date: September 2007
Detailed Description:
This is a randomized, crossover trial for patient with ALS and mild respiratory involvement. Patients with forced vital capacity above 60% of the predicted value can join. Patients will be assigned to either start using non-invasive ventilation at night or continue their usual care. After three months, patients will switch over to the other treatment group. For example, a patient who was initially assigned to continue their usual care would begin using non-invasive ventilation after three months.

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Probable or definite ALS by El Escorial criteria
  • age >17 years
  • FVC >60
  • minimal respiratory symptoms (no orthopnea or dyspnea at rest)
  • ability to provide informed consent

Exclusion Criteria:

  • Presence of another neurodegenerative disease
  • arterial CO2 above 45 mmHg
  • O2 below 60 mmHg
  • coexisting chronic lung disease unrelated to ALS
  • presence of an unstable medical condition such as coronary artery disease, liver failure, renal failure or cancer in the 30 days preceding enrollment
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00386464

United States, Maryland
Johns Hopkins University School of Medicine
Baltimore, Maryland, United States, 21205
Sponsors and Collaborators
Johns Hopkins University
National Heart, Lung, and Blood Institute (NHLBI)
Principal Investigator: Noah Lechtzin, MD Johns Hopkins University
Study Chair: Charles M Wiener, MD Johns Hopkins University
  More Information

Additional Information: Identifier: NCT00386464     History of Changes
Other Study ID Numbers: HL 67887-03
Study First Received: October 10, 2006
Last Updated: November 8, 2007

Keywords provided by Johns Hopkins University:
lou gehrigs disease
motor neuron disease
respiratory muscles

Additional relevant MeSH terms:
Motor Neuron Disease
Amyotrophic Lateral Sclerosis
Neurodegenerative Diseases
Nervous System Diseases
Neuromuscular Diseases
Spinal Cord Diseases
Central Nervous System Diseases
TDP-43 Proteinopathies
Proteostasis Deficiencies
Metabolic Diseases processed this record on August 21, 2017