Role of Natriuretic Peptides in the Treatment of Acutely Decompensated Heart Failure Patient With Obstructive Airways Disease (BNP in OAD)
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Purpose
Brain natriuretic peptide (BNP) is a useful therapy when treating patients with heart failure. As many of these patients also have airways disease it is important to determine if BNP also has a positive effect on their respiratory condition. The role of BNP in airways disease has never been studied although there is evidence to suggest that it will have a positive effect.
The current study is therefore a proof on concept study which will demonstrate whether BNP (nesiritide) will improve both heart failure and airflow obstruction in patient who have both.
The investigators are looking to enroll 40 patients with heart failure and airways disease who present to hospital emergency departments. Patients who consent and meet the entry criteria will be randomised to receive either nesiritide or placebo in addition to standard therapy. They will receive a bolus of study medication followed by a 4 hour infusion. Before, at hourly intervals and immediately following the infusion the following data will be collected:
- dyspnoea score
- respiratory rate
- FEV1 (if able to be performed)
- peak respiratory flow rates (PEFR, if able to be performed)
- requirement for concomitant bronchodilator therapy
- urinary GMP At all times during the study period and at the conclusion of the study patients will be provided with the best available therapy for their condition at the physicians' discretion.
| Condition | Intervention | Phase |
|---|---|---|
|
Heart Failure |
Drug: Nesiritide Drug: Placebo |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Role of Natriuretic Peptides in the Treatment of Acutely Decompensated Heart Failure Patient With Obstructive Airways Disease |
- To compare the need for and the length of time patients require non invasive ventilation when treated with nesiritide vs placebo. [ Time Frame: 24 hours ] [ Designated as safety issue: No ]
- dyspnoea score respiratory rate FEV1 PEFR requirement for concomitant bronchodilator therapy BNP [ Time Frame: 24 hours ] [ Designated as safety issue: No ]
| Enrollment: | 6 |
| Study Start Date: | September 2007 |
| Estimated Study Completion Date: | September 2009 |
| Primary Completion Date: | July 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: A
Nesiritide
|
Drug: Nesiritide
Nesiritide 4 hour infusion
|
|
Placebo Comparator: B
Placebo
|
Drug: Placebo
Placebo infusion
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Males and females
- Over 18 years of age
- Confirmed written informed consent.
- Acute decompensated heart failure based on physicians assessment and requiring treatment as per standard emergency department protocols for this condition.
- Requirement for intravenous therapy of HF, e.g. diuretic, vasodilator.
COAD based on physician's assessment and requiring treatment as per standard emergency department protocols for this condition. Must have at least 2 of the following criteria:
- history of smoking > 20 pack years,
- prior history of PFTs within last 1 year consistent with COAD,
- history of chronic cough and sputum production,
- progressive dyspnea, episodes of acute bronchitis over at least 2 yrs
Exclusion Criteria:
- Women lactating, pregnant or of childbearing potential not using 2 reliable contraceptive methods.
- Patients who had received an investigational new drug within the last 4 weeks.
- Patients with a history of a psychological illness or condition such as to interfere with the patient's ability to understand the requirements of the study.
- SBP <90mmHg
- Creatinine >0.25mmol/L
- Sp02 < 80% on supplemental oxygen or known cor pulmonale with TR
Contacts and Locations| Australia, Victoria | |
| Alfred Hospital | |
| Melbourne, Victoria, Australia, 3004 | |
| Principal Investigator: | Henry Krum, MBBS FRACP PhD | Monash University / Alfred Hospital |
| Principal Investigator: | Peter Cameron | Monash University / Alfred Hospital |
More Information
No publications provided
| Responsible Party: | Prof Henry Krum, Alfred Hospital |
| ClinicalTrials.gov Identifier: | NCT00562692 History of Changes |
| Other Study ID Numbers: | CP-02/05, Project No. 11/06 |
| Study First Received: | November 21, 2007 |
| Last Updated: | August 3, 2009 |
| Health Authority: | Australia: Department of Health and Ageing Therapeutic Goods Administration |
Keywords provided by The Alfred:
|
Heart failure OAD BNP Heart Failure patients who present to the emergency department |
Additional relevant MeSH terms:
|
Heart Failure Lung Diseases, Obstructive Heart Diseases Cardiovascular Diseases Lung Diseases Respiratory Tract Diseases |
Natriuretic Peptide, Brain Natriuretic Agents Physiological Effects of Drugs Pharmacologic Actions Cardiovascular Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 16, 2013