Asthma Clinical Trial
Official title:
Comparison of the Methacholine PC20 Between the Trudell Aeroeclipse* II Ban Nebulizer and the Wright Nebulizer
This study will compare the methacholine PC20 of two different modern-delivery aerosol systems to determine if one may replace the other for use in clinical settings.
Thirty three asthmatic subjects (>18 years, both sexes) who have stable asthma will be
recruited to undergo methacholine challenges for a randomized, crossover, observational
study. The objective of this study is to compare the methacholine PC20 of a modern delivery
aerosol system, the Trudell AeroEclipse*II BAN nebulizer, to that of the current "gold
standard", the English-Wright nebulizer. Subjects will inhale methacholine using both
nebulizing systems on separate visits and the PC20 values will be compared. The results from
these experiments will give us a better indication of whether the modern AeroEclipse* II BAN
nebulizer might be sufficient to replace the current "gold standard" Wright nebulizer in
clinical settings.
Baseline Spirometry
Baseline FEV1 and VC will be registered using an electronic spirometer meeting ATS
requirements.
Screening
A medical history will be conducted by interview and asthma medications will be reviewed on
this V1. Subjects will also undergo a Methacholine Challenge to determine their PC20 and
therefore their eligibility into the study.
Methacholine Challenge
Challenges will be carried out after a minimum 8-hour washout of short-acting ß2-agonist.
Subjects will perform methacholine challenges on 2 separate days at the same time of day, at
least 24-hours apart and all within a 2-week period. At V2, subjects will be randomly
assigned to use either the Wright nebulizer or the AeroEclipse*II BAN nebulizer.
Methacholine inhalation from the Wright nebulizer will be performed as follows. Subjects are
instructed to wear noseclips and to breathe normally from the mouthpiece during the 2-minute
inhalation period. Subjects inhale normal saline, then doubling concentrations of
methacholine for 2 minutes each always starting at a dose of 0.03 mg/ml. Spirometry is
measured with an electronic spirometer meeting ATS requirements. FEV1 is measured at 30 and
90 seconds after each inhalation and the highest FEV1 will be used to calculate the % fall
from baseline. There is a 3 minute interval between the end of one inhalation dose and start
of the next inhalation dose. The test is terminated when a fall in FEV1 of 20% of the
baseline value occurs and the methacholine PC20 is calculated. The same protocol will be
applied to methacholine inhalation using the AeroEclipse*II BAN nebulizer with the exception
that the 2-minute tidal breathing will be reduced to 20 seconds and the interval between the
end of one inhalation dose and start of the next inhalation dose is 3 minutes and 40
seconds. Subjects will return to the lab on V3 to complete a methacholine challenge using
the alternate nebulizer from the one used on V2.
DATA ANALYSIS
The methacholine PC20 values will be log-transformed before performing summary statistics.
The PC20 values will be compared by paired t-test.
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Allocation: Randomized, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Treatment
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