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RecruitingNCT03299231SIMPLEUpdated May 23, 2024

Oscillating Positive Expiratory Pressure Devices and Acute Exacerbation of Chronic Obstructive Pulmonary Disease

An interventional study of OPEP Aerobika and OPEP Aerobika Sham device in Pulmonary Disease, Chronic Obstructive, sponsored by Ain Shams University. Recruiting at 1 site in Egypt. Open to participants aged 40 Years and older. Per ClinicalTrials.gov, last updated 2024-05-23.

Sponsored by Ain Shams University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
160
Allocation
Randomized
Ages
40 Years and older
Sex
All
01

Study summary

Sputum production increases in acute exacerbation of COPD, both in amount and consistency. It increases airways obstruction and hence delays improvement and prolongs hospital stay. oscillating positive expiratory pressure (OPEP) devices were extensively studied in cystic fibrosis and bronchiectasis. Only seldom studied in chronic bronchitis. This study aims to measure the effects of mucous clearing device in hospitalized patients with acute exacerbation of COPD.

Read the detailed description

In this study, investigators will investigate the change of objective measurements of lung functions and exercise capacity in addition to subjective measures of quality of life.

02

Conditions studied

  • Pulmonary Disease, Chronic Obstructive

Keywords

  • COPD
  • acute exacerbation
  • OPEP
03

Who can participate

Ages eligible
40 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • COPD patients, stages 3-4 according to GOLD guidelines 2016, with post bronchodilator FEV1/FVC \< 70% of predicted and FEV1 \< 50% with exacerbations necessitates hospital admission.
  • Smokers or Ex-smokers.
  • Able and willing to provide informed signed consent. Able and understanding the correct use of the bronchial clearing device.
  • Able to perform effectively spirometry.
  • Able and willing to receive the management plane as indicated including systemic steroids if seemed necessary.

Exclusion criteria

Exclusion Criteria:

  • Other obstructive pulmonary diseases or those do not fulfill the criteria of COPD diagnosis.
  • Nonsmokers.
  • Presence of major comorbidity causing organ dysfunction as cardiac (including severe pulmonary hypertension), renal, or liver impairment (not including diabetes, arterial hypertension, or obesity).
  • Presence of lobar pneumonia.
  • Suspicion of bronchogenic malignancy.
  • Any other complication either at admission or during hospital stay as pneumothorax, pulmonary embolism, myocardial infarction, acute coronary syndrome, cerebrovascular accidents, ...
  • Patients unable or not willing to provide informed signed consent.
  • Patients unable to use the bronchial clearing device.
  • Patients unable to perform spirometry.
  • Patients unable or not willing to comply to the management plan or the study protocol.
  • Patients receiving regular oral steroids or non-selective beta blockers.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
160 participants (estimated)

Study arms

  • Active comparator
    Aerobika

    Group of participants with COPD, hospitalized for severe exacerbation and using the active oscillating positive expiratory pressure device (OPEP). The device is a hand held one. Used mostly in subjects with bronchiectasis for mucus clearing. Estimated number of subjects in this arm is 80. The device has an adjustable resistance which will be set by a health care provider in the study team. The device is to be used three times daily from 10 to 20 minutes according to subject's effort.

    Device: OPEP Aerobika

  • Sham comparator
    Sham device

    Group of participants using the same looking device which is devoid from nebulizer port valve so it is not functioning (sham device). The sham arm is a control arm. It will be used as the active comparator three times daily for 10 to 20 minutes according to subject's effort

    Device: OPEP Aerobika Sham device

Interventions

  • DeviceOPEP Aerobika

    Previous studies of OPEP device shows preliminary benefit in subjects with COPD. No serious adverse events were recorded in previous studies. The device is FDA registered.

  • DeviceOPEP Aerobika Sham device

    The same OPEP device which is devoid of the nebulizer port valve to render it inactive. Used for control sham arm.

05

What researchers measure

Primary outcomes

  1. percent change of Forced expiratory volume in first second (FEV1)

    change in volume of air expired forcefully in first second of expiration

    Time frame: at 12 weeks after hospital discharge

  2. percent change of Forced vital capacity (FVC)

    change in total volume of air expired forcefully

    Time frame: at 12 weeks after hospital discharge

  3. percent change of six minutes walking distance (6MWD)

    distance in meters a subject walk within 6 minutes

    Time frame: at 12 weeks after hospital discharge

Secondary outcomes

  1. change in health related quality of life

    measured by Saint George Respiratory Questionnaire

    Time frame: 12 weeks after hospital discharge

  2. change in score of shortness of breath

    measure by baseline and transitional dyspnea index

    Time frame: 12 weeks after hospital discharge

  3. hospital stay

    measured in days of hospital stay

    Time frame: first day of hospital admission to day of hospital discharge up to 12 weeks

  4. hospital readmission

    admission to hospital after 30 days of discharge due to COPD exacerbation

    Time frame: 4 weeks after discharge

  5. severe COPD exacerbation

    exacerbation of COPD need hospitalization

    Time frame: 12 weeks after discharge

  6. Moderate COPD exacerbation

    exacerbation of COPD need additional treatment as antibiotics and/or steroids

    Time frame: 12 weeks after discharge

06

Study locations

1 of 1 sites recruiting
  • Ain Shams University Hospital
    Cairo, Egypt
    • Ragi M Ghali, MsC · Contact · ragi.ghali@med.asu.edu.eg · +201063340684
    • Gihan H Alassal, M.D. · Contact · gelassal2006@gmail.com · +201001130465
    • Hesham H Raafat, M.D. · Principal investigator
    • Yasser Mostafa, M.D. · Sub investigator
    Recruiting
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03299231
Lead sponsor
Ain Shams University
Collaborators
Trudell Medical International
Responsible party
Hesham Raafat (Ass. Professor of chest medicine, Ain Shams University) — Principal investigator
First posted
Oct 3, 2017
Start date
Jan 22, 2018
Primary completion
Jul 2024 (estimated)
Completion
Oct 2024 (estimated)
Last update
May 23, 2024

Study contacts

Hesham H Raafat, M.D.
Contact
hesham.raafat@med.asu.edu.eg
+966592542751
Gihan Elassal, M.D.
Contact
gelassal2006@gmail.com
+201001130465
Vladimir Kushnarev
study director · Trudell Medical International
Hesham H Raafat, M.D.
principal investigator · Ain Shams University
Yasser Mostafa, M.D.
study director · Ain Shams University
Brian W Carlin
study director · West Penn Allegheny Health System

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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