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CompletedNCT03398213Updated Aug 21, 2020Results posted

Acupuncture Treatment of Chronic Obstructive Pulmonary Disease (COPD) Exacerbation

An interventional study of Acupuncture and Sham procedure in COPD Exacerbation, sponsored by Bnai Zion Medical Center. Completed at 2 sites in Israel. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-08-21.

Sponsored by Bnai Zion Medical Center · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
72
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Chronic obstructive pulmonary disease (COPD) is a major health problem. Acute exacerbations are a health-care burden involving frequent hospitalizations and elevated costs. They have effective therapies with significant side effects. Acupuncture has been shown to reduce dyspnea and other COPD-related symptoms. The investigators will compare the efficacy and safety of the addition of true acupuncture to usual care with both sham-acupressure added to usual care and usual care only for the treatment of acute exacerbations of COPD among inpatients.

Read the detailed description

This is an assessor-blinded randomized controlled trial in the setting of a tertiary academic medical center in Israel. Patients with clinical diagnosis of acute exacerbation of COPD will be randomized to either usual care only, usual care with true acupuncture or usual care with sham-acupressure. The primary outcome will be clinical improvement of dyspnea as measured by mBorg scale. Secondary outcomes included improvement of other patient-reported outcomes and physiologic features, as well as duration of hospitalization and treatment failure. Acupuncture-related side effects will be evaluated by the validated Acupuncture Adverse Events (AcupAE) questionnaire.

02

Conditions studied

03

Who can participate

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

Inclusion criteria

  • Previous diagnosis of COPD
  • Clinical diagnosis of acute exacerbation of COPD
  • Informed consent

Exclusion criteria

Exclusion Criteria:

  • Hemodynamic instability
  • Platelet count \< 20 x 10\^9/L
  • Expected respiratory deterioration requiring mechanical ventilation in the next 24 hours
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
72 participants (actual)

Study arms

  • Experimental
    Acupuncture

    Acupuncture for treatment of COPD exacerbation + standard conventional care for COPD exacerbation

    Other: Acupuncture

  • Sham comparator
    Sham procedure

    Ear stimulation with plaster + standard conventional care for COPD exacerbation

    Other: Sham procedure

  • No intervention
    Standard care

    Standard conventional care for COPD exacerbation

Interventions

  • OtherAcupuncture

    Acupuncture

  • OtherSham procedure

    Ear stimulation with plaster

05

What researchers measure

Primary outcomes

  1. Dyspnea Intensity

    modified Borg (mBorg) scale, which is a validated scale that has been used to evaluate the degree of dyspnea (0- no dyspnea, to 10- worse dyspnea)

    Time frame: At baseline, day 1 after treatment, day 2 before treatment, day 2 after treatment, day 3 before treatment, day 3 after treatment, day 4 before treatment, and day 4 after treatment

Secondary outcomes

  1. Duration of Hospitalization

    Days of hospitalization

    Time frame: Through study completion, an average of 1 week

  2. Carbon Dioxide Partial Pressure (pCO2)

    pCO2

    Time frame: Day 1, day 2, day 3, and day 4 of the study

  3. Power of Hydrogen (pH)

    pH

    Time frame: Day 1, day 2, day 3, and day 4 of the study

  4. Respiratory Rate

    Respiratory rate

    Time frame: At baseline, day 1 after treatment, day 2 before treatment, day 2 after treatment, day 3 before treatment, day 3 after treatment, day 4 before treatment, and day 4 after treatment

  5. Oxygen Saturation

    Oxygen saturation

    Time frame: Day 1, day 2, day 3, and day 4 of the study

  6. Cough Intensity

    Visual Analogue Scale (VAS) for cough (0- no cough, to 10- worse cough)

    Time frame: Day 1, day 2, day 3, and day 4 of the study

  7. Sputum Intensity

    Visual Analogue Scale (VAS) for sputum (0- no sputum, to 10- worse sputum)

    Time frame: Day 1, day 2, day 3, and day 4 of the study

06

Results

Posted Aug 11, 2020

Participant flow

Participant flow — Overall Study
MilestoneAcupunctureSham ProcedureStandard Care
Started262422
Completed262422
Not completed000

Outcome measures

PrimaryDyspnea Intensity

modified Borg (mBorg) scale, which is a validated scale that has been used to evaluate the degree of dyspnea (0- no dyspnea, to 10- worse dyspnea)

Time frame:
At baseline, day 1 after treatment, day 2 before treatment, day 2 after treatment, day 3 before treatment, day 3 after treatment, day 4 before treatment, and day 4 after treatment
Reported as:
Median · units on a scale
Dyspnea Intensity
units on a scaleAcupunctureSham ProcedureStandard Care
Baseline8.0 (5.5 to 8.75)6.5 (5.0 to 8.5)7.75 (6.0 to 8.5)
Day 1 after treatment5 (4.0 to 5.0)6 (4.25 to 7.8)7 (5.5 to 8.0)
Day 2 before treatment5 (3.5 to 7)6.75 (5 to 8.5)7.5 (5.8 to 8.3)
Day 2 after treatment2 (1 to 3)5 (3 to 7)7.5 (5 to 8)
Day 3 before treatment2.5 (1 to 5)6 (4.5 to 7.3)5.75 (4.5 to 7)
Day 3 after treatment2 (1 to 3)6 (5 to 7)6 (2 to 7)
Day 4 before treatment3 (0 to 5)5.5 (3 to 8)7 (5 to 8.5)
Day 4 after treatment1 (0 to 3)5 (4 to 6)6 (5 to 7)
SecondaryDuration of Hospitalization

Days of hospitalization

Time frame:
Through study completion, an average of 1 week
Reported as:
Mean · days
Duration of Hospitalization
daysAcupunctureSham ProcedureStandard Care
Duration of Hospitalization5.5 ± 2.36.0 ± 2.96.3 ± 2.9
SecondaryCarbon Dioxide Partial Pressure (pCO2)

pCO2

Time frame:
Day 1, day 2, day 3, and day 4 of the study
Reported as:
Count of participants · Participants
Carbon Dioxide Partial Pressure (pCO2)
ParticipantsAcupunctureSham ProcedureStandard Care
Day 1 — < 45 mmHg638
Day 1 — 45-60 mmHg12179
Day 1 — 60-80 mmHg545
Day 1 — > 80 mmHg300
Day 2 — < 45 mmHg471
Day 2 — 45-60 mmHg463
Day 2 — 60-80 mmHg752
Day 2 — > 80 mmHg312
Day 3 — < 45 mmHg134
Day 3 — 45-60 mmHg593
Day 3 — 60-80 mmHg421
Day 3 — > 80 mmHg211
Day 4 — < 45 mmHg122
Day 4 — 45-60 mmHg160
Day 4 — 60-80 mmHg333
Day 4 — > 80 mmHg101
SecondaryPower of Hydrogen (pH)

pH

Time frame:
Day 1, day 2, day 3, and day 4 of the study
Reported as:
Count of participants · Participants
Power of Hydrogen (pH)
ParticipantsAcupunctureSham ProcedureStandard Care
Day 1 — < 7.2000
Day 1 — 7.2-7.3541
Day 1 — > 7.3212021
Day 2 — < 7.2000
Day 2 — 7.2-7.3634
Day 2 — > 7.312164
Day 3 — < 7.2010
Day 3 — 7.2-7.3202
Day 3 — > 7.37147
Day 4 — < 7.2000
Day 4 — 7.2-7.3002
Day 4 — > 7.36114
SecondaryRespiratory Rate

Respiratory rate

Time frame:
At baseline, day 1 after treatment, day 2 before treatment, day 2 after treatment, day 3 before treatment, day 3 after treatment, day 4 before treatment, and day 4 after treatment
Reported as:
Median · breaths per minute
Respiratory Rate
breaths per minuteAcupunctureSham ProcedureStandard Care
Baseline (day 1)21 (16 to 23.75)22 (16.5 to 26)20 (16 to 22)
Day 1 after treatment16 (14 to 20)18 (16 to 20.5)21 (18 to 26)
Day 2 before treatment18 (16 to 22)20 (16 to 25)22 (16 to 24)
Day 2 after treatment16 (12 to 16)18 (16 to 21.5)26 (21 to 30)
Day 3 before treatment16 (14 to 29)18 (16 to 24)18 (16 to 22)
Day 3 after treatment14 (12 to 20)16 (16 to 24)24 (18 to 24)
Day 4 before treatment16 (14 to 29)16 (16 to 23)18 (16 to 18)
Day 4 after treatment13 (12 to 17)16 (14 to 20)22 (18 to 26)
SecondaryOxygen Saturation

Oxygen saturation

Time frame:
Day 1, day 2, day 3, and day 4 of the study
Reported as:
Count of participants · Participants
Oxygen Saturation
ParticipantsAcupunctureSham ProcedureStandard Care
Day 1 — =< 80%410
Day 1 — 81-89%91010
Day 1 — >= 90%131312
Day 2 — =< 80%242
Day 2 — 81-89%10105
Day 2 — >= 90%121012
Day 3 — =< 80%030
Day 3 — 81-89%1076
Day 3 — >= 90%91311
Day 4 — =< 80%100
Day 4 — 81-89%432
Day 4 — >= 90%61412
SecondaryCough Intensity

Visual Analogue Scale (VAS) for cough (0- no cough, to 10- worse cough)

Time frame:
Day 1, day 2, day 3, and day 4 of the study
Reported as:
Median · units on a scale
Cough Intensity
units on a scaleAcupunctureSham ProcedureStandard Care
Day 17.5 (5.0 to 8.0)5.0 (5.0 to 7.3)5.0 (4 to 7.5)
Day 24.5 (1.5 to 5.5)5 (2.5 to 7.5)5 (4.5 to 7.5)
Day 33 (1 to 5)5 (3.3 to 7.3)5 (2.5 to 7.5)
Day 42.5 (2 to 4)4.5 (2.5 to 6)5 (0 to 7.5)
SecondarySputum Intensity

Visual Analogue Scale (VAS) for sputum (0- no sputum, to 10- worse sputum)

Time frame:
Day 1, day 2, day 3, and day 4 of the study
Reported as:
Median · units on a scale
Sputum Intensity
units on a scaleAcupunctureSham ProcedureStandard Care
Day 16.0 (2 to 7.5)6.0 (4.5 to 6.0)5.0 (2.5 to 6.0)
Day 22.8 (1 to 4.5)5.5 (2 to 6)4.5 (2.5 to 5.5)
Day 32 (1 to 4)5 (3.5 to 6)4.5 (2.5 to 5)
Day 42 (1 to 4)5 (3 to 6)5 (2.5 to 6)

Adverse events

Collected over 4 days. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Acupuncture0/26 (0%)0/26 (0%)0/26 (0%)
Sham Procedure0/24 (0%)0/24 (0%)0/24 (0%)
Standard Care0/22 (0%)0/22 (0%)0/22 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)AcupunctureSham ProcedureStandard CareTotal
Mean69.2 ± 10.170.7 ± 8.167.4 ± 9.369.13 ± 9.2
Sex: Female, Male
Sex: Female, Male(Participants)AcupunctureSham ProcedureStandard CareTotal
Female69520
Male20151752
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)AcupunctureSham ProcedureStandard CareTotal
Count of participants———0
Dyspnea intensity
Dyspnea intensity(units on a scale)AcupunctureSham ProcedureStandard CareTotal
Median8 (5.5 to 8.75)6.5 (5 to 8.5)7.75 (6 to 8.5)7.5 (5 to 8.5)
07

Study locations

2 sites
  • Bnai Zion Medical Center
    Haifa, Golomb 47 3104802, Israel
  • Bnai Zion Medical Center
    Haifa, Israel
08

References and documents

Publications

  • Levy I, Elimeleh Y, Gavrieli S, Attias S, Schiff A, Oliven A, Schiff E. Treatment of acute exacerbations of chronic obstructive pulmonary disease with acupuncture during hospitalization: a three-arm double-blinded randomized sham-controlled trial. Acupunct Med. 2022 Dec;40(6):505-515. doi: 10.1177/09645284221086293. Epub 2022 May 17. PubMed 35579025 ↗

Study documents

  • Protocol and statistical analysis plan · Jun 3, 2020

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03398213
Lead sponsor
Bnai Zion Medical Center
Responsible party
Sponsor
First posted
Jan 12, 2018
Start date
Jan 14, 2018
Primary completion
Dec 25, 2019
Completion
Mar 1, 2020
Results posted
Aug 11, 2020
Last update
Aug 21, 2020

Study contacts

Elad Schiff, M.D.
principal investigator · Bnai Zion Medical Center

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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