Pulmonary Disease, Chronic Obstructive Clinical Trial
Official title:
Comparison of Conventional Medicine, TCM Treatment and Combination of Both Conventional Medicine and TCM Treatment for Patients With Chronic Obstructive Pulmonary Disease: A Randomized Comparative Effectiveness Research Trial
The aim of this study is to compare the effectiveness and economic evaluation of three treatments for Chronic Obstructive Pulmonary Disease (COPD) patients: one, conventional medicine based on 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) and Chinese Treatment Guidelines; another, TCM treatments, which have been evaluated and have certain effect; and finally, combination of both conventional medicine and TCM treatment, then determine which treatment is the most suitable for COPD patients.
COPD affects millions worldwide. The high prevalence, morbidity, mortality and economic
burdens of COPD are increasing steadily. Although many therapies exist and are being
developed to relieve symptoms and reduce mortality in COPD, most have only been studied in
placebo-controlled efficacy studies in highly selected populations. There are few clinical
trials to compare therapeutic alternatives in real world. Much of the comparative research
evidence in COPD has been based on observational studies. Furthermore, studies in real world
populations of COPD that received different therapies that do have efficacy evidence was
found wide variations in care delivery. These considerations highlight the need to identify
the most effective therapies in real world COPD patients and to design and test efforts to
translate this evidence into healthcare for the millions of COPD patients. In short, there
is a need for comparative effectiveness research (CER) in COPD.
CER has received growing attention worldwide. The direct comparisons of treatment
alternatives provided by CER can help patients and providers make best informed treatment
decisions where such evidence was previously lacking. Some randomized controlled trials on
comprehensive Traditional Chinese medicine (TCM) interventions, especially based on the TCM
patterns, have been the certain evidence for showing definite effect for stable COPD
patients. When facing many treatment approaches, how to choose the most suitable treatment
is difficult to identify. Hence, the aim of this study is to compare the effectiveness and
economic evaluation of three treatments for COPD patients and then determine which treatment
is the most suitable for COPD patients. conventional medicine, TCM treatment and Combination
of both conventional medicine and TCM treatment.
This is a multi-center, pragmatic, randomized, controlled trial to evaluate the
effectiveness of three treatments in COPD subjects. Following a 14 day run-in period,
approximately 360 subjects will be randomly assigned to one of the three treatments
(conventional medicine, Traditional Chinese medicine, and combination of both conventional
medicine and TCM treatment) for 26 weeks. After the 26 weeks treatment period, subjects in
three treatments arms will follow-up 26 weeks. The primary outcome measure is the frequency
of exacerbations. and. Secondary efficacy measures include FEV1, Dyspnea (MMRC), Exercise
Capacity( 6MWD), Quality of life (CAT) and economic evaluation(CEA, CUA). Safety will be
assessed through the collection of adverse events. There will be a total of 5 study visits
(baseline, the 13, 26 weeks of the treatment, 13 and 26 weeks of follow-up). A follow-up
contact for collection of effect and economic evaluation will be conducted approximately 26
weeks following the last study visit.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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