ClinicalTrials.gg
RecruitingNCT07160322RB-COPDUpdated Sep 8, 2025

Refractory Breathlessness in COPD

An observational study in COPD, sponsored by Seoul National University. Recruiting at 1 site in South Korea. Open to participants aged 18 Years to 100 Years. Per ClinicalTrials.gov, last updated 2025-09-08.

Sponsored by Seoul National University · Observational

From the registry’s dates

  • Started Apr 2024; still recruiting 2 years 7 months later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
730
Ages
18 Years to 100 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 148 studies in Pulmonary Disease, Chronic Obstructive with a site in Korea, Republic of — 19 open to participants now, 26 under way, 7 of them phase 3. Pulmonary Disease, Chronic Obstructive · Korea, Republic of.

Planned enrollment
13th of 32
730 · median 432
Started
2024
with 4 others
Observational
32 of 148
8 open now
Primary completion
2030-12
later than 23 of 25 live
Registered
140th of 148
by date

Among the 148 studies in Pulmonary Disease, Chronic Obstructive with a site in Korea, Republic of, this one is the 13th largest by planned enrollment of the 32 observational ones that give a count, is one of 5 that started in 2024, is one of 32 observational ones, reaches primary completion later than 23 of the 25 other live ones, and was the 140th registered.

Pulmonary Disease, Chronic Obstructive

5,520 studies on the registry are indexed under Pulmonary Disease, Chronic Obstructive; 856 are open to participants now.

Browse Pulmonary Disease, Chronic Obstructive studies →

Open to participants now

19 of the 148 studies in Pulmonary Disease, Chronic Obstructive with a site in Korea, Republic of are open now. Recruiting first, the newest first:

13 more — sign in →

All 19 open studies →

A study can be open while its sites in Korea, Republic of have not opened yet or have stopped. Only those recruiting at a site in Korea, Republic of →

Who these studies take

Of the 555 Pulmonary Disease, Chronic Obstructive studies recruiting now, 305 (55%) set no upper age limit and 82 (15%) stop at 75 or younger; 29 take children under 18; 87 take healthy volunteers.

This study: 18 Years to 100 Years · all sexes · no healthy volunteers.

The full table on the hub →

This tab as a report to print or save as PDF → With an account.

Was this useful?
Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 148 studies in Pulmonary Disease, Chronic Obstructive with a site in Korea, Republic of, or all of them as a file.
02

Study summary

This study aims to investigate the prognosis and clinical outcomes of patients with chronic obstructive pulmonary disease (COPD) who continue to experience refractory dyspnea despite treatment with long-acting beta-agonist (LABA) and long-acting muscarinic antagonist (LAMA). The research will prospectively follow a cohort of patients to identify clinical factors, lung function parameters, imaging features, and cardiovascular indicators associated with poor treatment response. By comparing these patients with those who show symptom improvement, the study seeks to determine predictors of exacerbations, lung function decline, and mortality. Findings are expected to guide the development of targeted strategies to improve the management of refractory dyspnea in COPD.

Read the detailed description

The study aims to identify actionable clinical factors and develop predictive models that can enhance personalized management approaches for patients with refractory dyspnea in COPD.

This is a prospective observational cohort study designed to characterize patients with COPD who remain symptomatic despite standard inhaled therapy with LABA/LAMA combination. Participants will be enrolled from outpatient clinics and followed over time to assess changes in respiratory symptoms, lung function, exercise capacity, acute exacerbation frequency, and survival.

Key assessments include:

  • Baseline demographic and clinical data (e.g., respiratory symptoms, comorbidities, smoking history).
  • Pulmonary function tests (spirometry and lung volumes), exercise capacity evaluations, echocardiography, chest radiographs, and computed tomography (CT).
  • Biomarker analysis (blood tests including inflammatory and cardiac markers).

Patients will be classified into two groups:

  • Refractory COPD group - Patients with minimal improvement in dyspnea (defined as modified Medical Research Council (mMRC) ≥ 2 with \<1 point reduction or COPD Assessment Test (CAT) ≥ 10 with \<4 point reduction after ≥3 months of LABA/LAMA therapy).
  • Control group - Patients showing symptomatic improvement with the same therapy (mMRC \<2 or ≥1 point reduction, or CAT \<10 or ≥4 point reduction).

The primary analyses will explore clinical and physiological predictors of poor outcomes, using advanced statistical modeling such as linear mixed-effects models for longitudinal lung function trends, negative binomial regression for exacerbation risk, and Cox proportional hazards models for survival analysis.

Assessments:

Baseline and follow-up evaluations will include demographic and clinical data, comorbidities, smoking history, inhaler adherence and technique, spirometry, lung volume measurements, 6-minute walk tests, echocardiography, chest radiographs, and high-resolution CT scans. Blood tests will include complete blood count, inflammatory markers (C-reactive protein (CRP), fibrinogen), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and cardiac enzymes.

Statistical Analysis:

Longitudinal trends: Changes in lung function, symptoms, and exercise capacity will be assessed using linear mixed-effects models to evaluate the influence of clinical factors.

Acute exacerbations: The frequency of moderate-to-severe exacerbations will be analyzed using negative binomial regression or zero-inflated models when appropriate.

Mortality: Logistic regression will estimate 1-, 3-, and 5-year mortality risk, while Cox proportional hazards models will evaluate time-to-event outcomes.

Predictive modeling: Candidate biomarkers and imaging features will be incorporated into multivariable predictive models to identify key determinants of poor prognosis.

03

Conditions studied

  • COPD

Keywords

  • Chronic Obstructive Pulmonary Disease (COPD)
  • Refractory Breathlessness
  • Persistent Dyspnea
  • Treatment Resistance
  • Unresponsive to Therapy
04

Who can participate

Ages eligible
18 Years to 100 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

This study will enroll adult patients (≥ 18 years) diagnosed with chronic obstructive pulmonary disease (COPD) according to the GOLD 2025 criteria, who are receiving combination therapy with long-acting beta2-agonist (LABA) and long-acting muscarinic antagonist (LAMA). Participants include both patients who continue to experience refractory dyspnea despite treatment and those who show symptomatic improvement. All participants must be able to attend regular outpatient visits and provide written informed consent.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Adults (≥ 18 years) diagnosed with (COPD) according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2025 criteria:
  • Presence of COPD risk factors (e.g., smoking history, occupational exposure, genetic predisposition).
  • Typical symptoms such as dyspnea, cough, or sputum production.
  • Post-bronchodilator /FVC \< 0.70.
  • Regular outpatient follow-up at the respiratory clinic.
  • Received LABA/LAMA combination therapy for at least 3 months prior to enrollment.
  • Ability and willingness to provide written .

Exclusion criteria

Exclusion Criteria:

  • Poor adherence to LABA/LAMA therapy (medication possession rate \< 50%) or refusal of treatment.
  • Inability or unwillingness to comply with scheduled visits, examinations, or follow-up procedures.
  • Presence of severe comorbid conditions expected to significantly affect prognosis, including:

    • End-stage diseases with \< 1 year.
    • Terminal receiving hospice or palliative care.
  • Any condition that, in the opinion of the investigator, would interfere with study participation or data reliability.
Terms in these criteria, in plain language(5)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

FEV1

From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
730 participants (estimated)
Target follow-up
5 Years
Patient registry
Yes

Groups and cohorts

  • COPD patients with refractory breathlessness despite LABA/LAMA therapy

    Patients with COPD who continue to experience clinically significant dyspnea (mMRC ≥ 2 or CAT ≥ 10) despite at least 3 months of treatment with dual long-acting bronchodilator therapy (LABA/LAMA), showing less than a 1-point reduction in mMRC or less than a 4-point reduction in CAT scores compared with baseline.

06

What researchers measure

Primary outcomes

  1. Annual rate of acute exacerbations in COPD

    Annualized rate of moderate-to-severe exacerbations per patient-year, defined as episodes requiring systemic corticosteroids, antibiotics, or hospitalization. Moderate exacerbations will be defined as events requiring treatment with systemic corticosteroids and/or antibiotics without hospitalization. Severe exacerbations will be defined as events leading to hospitalization or emergency department visit. Unit: Number of exacerbations per patient-year

    Time frame: Up to 5 years (annualized rate)

  2. All-cause mortality

    Proportion of participants who die from any cause Unit: Percentage of participants (%) or Number of deaths

    Time frame: 1-, 3-, and 5-year follow-up.

Secondary outcomes

  1. Annual forced expiratory volume in one second (FEV1) decline rate

    Rate of change in forced expiratory volume in one second (FEV1) (Milliliters per year (mL/year)) measured by spirometry Annual decline in FEV1 will be assessed using linear mixed-effects models.

    Time frame: Baseline and annually for up to 5 years.

  2. Annual forced expiratory volume in one second to forced vital capacity ratio (FEV1/FVC ratio) decline rate

    Rate of change in post-bronchodilator forced expiratory volume in one second to forced vital capacity (FEV1/FVC ) ratio (%/year) measured by spirometry Annual decline in FEV1/FVC will be assessed using linear mixed-effects models.

    Time frame: Baseline and annually for up to 5 years.

Other outcomes

  1. Change in modified Medical Research Council (mMRC) dyspnea scores from baseline

    Mean change in mMRC score from baseline Unit: Score units (0-4 scale)

    Time frame: Baseline, 3-6 months, and annually for up to 5 years.

  2. Change in CAT scores from baseline

    Mean change in CAT score from baseline Unit: Score units (0-40 scale)

    Time frame: Baseline, 3-6 months, and annually for up to 5 years.

  3. Change in Charlson Comorbidity Index (CCI) from baseline

    Mean change in CCI score Unit: Score units

    Time frame: Baseline and annually for up to 5 years.

  4. Change in COPD-specific Comorbidity Test (COTE) index from baseline

    Mean change in COTE index Unit: Score units

    Time frame: Baseline and annually for up to 5 years.

  5. Change in COPD Comorbidity (COMCOLD) index from baseline

    Mean change in COMCOLD index Unit: Score units

    Time frame: Baseline and annually for up to 5 years.

  6. Change in medication possession rate (MPR) from baseline

    Mean change in MPR, expressed as % of days with medication available Unit: Percentage (%)

    Time frame: Baseline and annually for up to 5 years.

  7. Change in proportion of days covered (PDC) from baseline

    Mean change in PDC, expressed as % of days with medication available Unit: Percentage (%)

    Time frame: Baseline and annually for up to 5 years.

  8. Change in white blood cell (WBC) from baseline

    Mean change in WBC count from baseline Unit: ×10⁹ cells/L

    Time frame: Baseline and annually for up to 5 years.

  9. Change in blood eosinophil count (BEC) from baseline

    Mean change in BEC from baseline Unit: cells/L

    Time frame: Baseline and annually for up to 5 years.

  10. Change in immunoglobulin E (IgE) from baseline

    Mean change in IgE from baseline Unit: International Units per milliliter (IU/mL)

    Time frame: Baseline and annually for up to 5 years.

  11. Change in fibrinogen from baseline

    Mean change in fibrinogen from baseline Unit: milligrams per deciliter (mg/dL)

    Time frame: Baseline and annually for up to 5 years.

  12. Change in cortisol from baseline

    Mean change in cortisol measured at 8 AM from baseline Unit: micrograms per deciliter (µg/dL)

    Time frame: Baseline and annually for up to 5 years.

  13. Change in C-reactive protein (CRP) from baseline

    Mean change in CRP from baseline Unit: milligrams per liter (mg/L)

    Time frame: Baseline and annually for up to 5 years.

  14. Change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) from baseline

    Mean change in NT-proBNP from baseline Unit: picograms per milliliter (pg/mL)

    Time frame: Baseline and annually for up to 5 years.

  15. Change in Troponin I from baseline

    Mean change in Troponin I from baseline Unit: nanograms per milliliter (ng/mL)

    Time frame: Baseline and annually for up to 5 years.

  16. Change in difference between respiratory resistance at 5 Hz and 20 Hz (R5-R20) from baseline

    Mean change in R5-R20 from baseline Unit: cmH₂O/L/s

    Time frame: Baseline and annually for up to 5 years.

  17. Change in resonant frequency (Fres) from baseline

    Mean change in Fres from baseline Unit: Hertz (Hz)

    Time frame: Baseline and annually for up to 5 years.

  18. Change in reactance at 5 Hz (X5) from baseline

    Mean change in X5 from baseline Unit: cmH₂O/L/s

    Time frame: Baseline and annually for up to 5 years.

  19. Change in area of reactance (AX) from baseline

    Mean change in AX from baseline Unit: cmH₂O/L

    Time frame: Baseline and annually for up to 5 years.

  20. Change in parametric response mapping of functional small airway disease (PRMfSAD) in chest CT from baseline

    Mean change in PRMfSAD from baseline Unit: Percentage of lung volume (%)

    Time frame: Baseline and annually for up to 5 years.

  21. Change in low attenuation area in inspiratory chest CT from baseline

    Mean change in low attenuation area (\<-950 Hounsfield unit (HU)) in inspiratory chest CT from baseline Unit: Percentage of lung volume (%)

    Time frame: Baseline and annually for up to 5 years.

  22. Change in low attenuation area in expiratory chest CT from baseline

    Mean change in low attenuation area (\<-856 hounsfield unit (HU)) in expiratory chest CT from baseline Unit: Percentage of lung volume (%)

    Time frame: Baseline and annually for up to 5 years.

  23. Change in square root of wall area for a theoretical airway with 10 mm internal perimeter (Pi10) in chest CT from baseline

    Mean change in square root of wall area for a theoretical airway with 10 mm internal perimeter (Pi10) from baseline Unit: millimeters (mm)

    Time frame: Baseline and annually for up to 5 years.

07

Study locations

1 of 1 sites recruiting
  • Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center
    Seoul, Seoul 07061, South Korea
    Recruiting
08

References and documents

Individual participant data

Plan to share: No — Individual participant data will not be shared because the dataset contains sensitive personal health information, and there are no current plans or infrastructure for secure data sharing. Data will be used solely for analyses specified in the approved protocol and will remain confidential in accordance with institutional and IRB guidelines.

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Apr 2024 (actual). Primary completion is estimated for Dec 2030, 80 months after the start.

Of 466 non-industry observational studies under Pulmonary Disease, Chronic Obstructive, half reached primary completion within 29 months of starting (the median), counting those still running; a quarter within 15 and three quarters within 64. This study's planned 80 months is above that.

Counting every sponsor, half of 586 studies reached it within 26 months; a quarter within 14 and three quarters within 58.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 20, 2025
First posted
Sep 8, 2025
StartActual
Apr 11, 2024
Primary completionEst.
Dec 31, 2030
CompletionEst.
Dec 31, 2031
Last update
Sep 8, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 8, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07160322
Lead sponsor
Seoul National University
Responsible party
Hyun Woo Lee (Assistant professor, Seoul National University) — Principal investigator
First posted
Sep 8, 2025
Start date
Apr 11, 2024
Primary completion
Dec 31, 2030 (estimated)
Completion
Dec 31, 2031 (estimated)
Last update
Sep 8, 2025

Study contacts

Hyun Woo Lee, M.D.
Contact
athrunzara86@snu.ac.kr
82-10-9755-6172

Oversight

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

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion