Chronic Obstructive Pulmonary Disease Clinical Trial
Official title:
Effect of Doxofylline on Bronchial Obstruction, in add-on to Maximal Inhalation Therapy, in Clinically Stable COPD Patients.
It is a phase IV, prospective, interventional, single blind, randomized, crossover trial in which the investigators will evaluate the effects of a 4-week treatment with doxofylline 400 mg bid, in add-on to maximal inhalation therapy, in clinically stable COPD patients.
The investigators will evaluate the effects of a 4-week treatment with doxofylline 400 mg, in
add-on to maximal inhalation therapy (bronchodilators with or without a fixed dose
combination with inhaled corticosteroids), in clinically stable COPD patients.
After screening and collection of informed consent, study participants will undergo a 7-day
run-in, during which compliance to inhaled therapy and clinical stability will be assessed.
On the first visit patients will complete questionnaires (CAT, mMRC and SGRQ) to assess
baseline respiratory function and health related quality of life.
After the first visit, patients will undergo a washout period during which the inhaled
therapy will be withheld for 24 hours (7 days in case of chronic therapy with tiotropium).
The following day (the 8th day in case of tiotropium use), patients will perform the baseline
measurement of the following:
1. plethysmography
2. DLCO
3. maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP)
4. 6-minute walk test (6MWT) with the assessment of dyspnea scale (Borg scale) at rest and
after exercise.
Sixty minutes after the administration of the usual chronic inhalation therapy, patients will
then perform the same respiratory lung functional bundle of tests as detailed above (from 1
to 3).
Subsequently, patients will be randomized in two parallel arms (arm A and arm B). Patients
assigned to arm A will be prescribed 30-day treatment with doxofylline 400 mg bid, in
addition to their chronic inhalation therapy, and will take the first dose of the medication;
patients assigned to arm B will have their chronic therapy unchanged.
Randomization, drug administration and patient training will be performed by an operator not
involved in patients' recruitment, data collection and analysis.
180 minutes after the administration of the usual chronic inhalation therapy, patients will
repeat the lung function bundle from point 1 to 3.
During the subsequent 4-week treatment, patients' compliance will be monitored by telephone
calls. Any adverse event will be registered and will be treated according to our center's
standard operating procedures and good clinical practice by the treating physician.
After 4 weeks, before the administration of the morning dose, patients will be asked to
complete the CAT, mMRC and SGRQ questionnaires and to perform the baseline functional bundle
detailed in points 1 to 4. Patients will be asked to take the home inhalation therapy, as
well as doxofylline if arm A. Respiratory function tests from points 1 to 3 will be repeated
60 minutes after drug administration. After that, patients assigned to Arm B will take the
first dose of doxofylline. Respiratory function tests from points 1 to 3 will then be
repeated 180 minutes after inhalation therapy administration. Eventually, the 6-MWT will be
performed by patients assigned to Arm A, with assessment of the Borg dyspnea scale.
During the subsequent 4 weeks, patients assigned to arm B will be prescribed therapy with
doxofylline 400 mg bid in addition to their chronic inhalatory therapy, while patients
assigned to arm A will have only their usual chronic inhalation therapy. Compliance
monitoring and adverse event management will be handled as previously discussed.
At the end of the 4 weeks, before the administration of the morning dose, patients will be
asked to complete the CAT, mMRC and SGRQ questionnaires and to perform the baseline
functional bundle detailed in points 1 to 4. Patients will be asked to take the home
inhalation therapy, as well as doxofylline if arm B. Respiratory function tests from points 1
to 3 will be repeated 60 minutes and 180 minutes after drug administration. Eventually, the
6-MWT will be performed by patients assigned to Arm B, with assessment of the Borg dyspnea
scale.
A 30-day follow up will be performed after the last visit, in order to register any late drug
adverse reaction or adverse events..
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