Angiotensin-converting Enzyme (ACE)-Inhibition and Mechanisms of Skeletal Muscle Weakness in Chronic Obstructive Pulmonary Disease (COPD)
Recruitment status was Recruiting
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Purpose
A double blind randomised placebo controlled parallel trial of the effect of fosinopril, an angiotensin converting enzyme inhibitor, on the quadriceps muscle in 80 COPD patients who have quadriceps weakness. Patients will have a baseline assessment including measures of quadriceps strength and endurance and a quadriceps biopsy. Patients with weakness will be randomised to ACE inhibitor or placebo and re-assessed after three months of treatment.
The investigators aim to show that ACE-inhibition will alter the IGF-1/AKT/FoXO/atrogene pathways involved in muscle wasting in COPD.
| Condition | Intervention | Phase |
|---|---|---|
|
Chronic Obstructive Pulmonary Disease |
Drug: Fosinopril Other: lactose |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Treatment |
| Official Title: | ACE-inhibition and Mechanisms of Skeletal Muscle Weakness in Chronic Obstructive Pulmonary Disease |
- Changes in phosphorylation of components of the atrogene pathway [ Time Frame: 3 months ] [ Designated as safety issue: No ]
- Quadriceps endurance assessed non-volitionally [ Time Frame: 3 months ] [ Designated as safety issue: No ]
- Effect of ACE-I on quadriceps maximum voluntary contraction force [ Time Frame: 3 months ] [ Designated as safety issue: No ]
- Effect of ACE-I on quadriceps bulk (cross-sectional area) [ Time Frame: 3 months ] [ Designated as safety issue: No ]
- Effect of ACE-I on systemic inflammation and serum IGF-1 [ Time Frame: 3 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 80 |
| Study Start Date: | October 2009 |
| Estimated Study Completion Date: | September 2012 |
| Estimated Primary Completion Date: | September 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: ACE-inhibitor |
Drug: Fosinopril
10mg od
|
| Placebo Comparator: Sugar Pill |
Other: lactose
placebo
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Adult patient with COPD diagnosed according to GOLD criteria.
Exclusion Criteria:
- Clinically unstable patients (within one month of exacerbation), those with a permanent pacemaker (which is a contraindication to magnetic stimulation), or significant co-morbidity, patients with an accepted indication for ACE inhibition (left ventricular dysfunction, diabetes) or a contraindication such as renovascular disease; creatinine clearance (estimated) <50); hypotension; use of anticoagulants (contra-indication to biopsy) or ACE-I or ATII receptor antagonists.
- Allergy to ACE-inhibitors.
- Pregnancy.
Patients will not be enrolled within three months of participation in a pulmonary rehabilitation program.
Contacts and Locations| Contact: Dinesh Shrikrishna, BSc, MRCP | 0207 351 8029 | d.shrikrishna@ic.ac.uk |
| Contact: Nicholas S Hopkinson, MRCP, PhD |
| United Kingdom | |
| Royal Brompton Hospital | Recruiting |
| London, United Kingdom, SW3 6NP | |
| Contact: Dinesh Shrikrishna, BSc, MRCP 0207 351 8029 | |
| Principal Investigator: Nicholas S Hopkinson, MRCP, PhD | |
| Sub-Investigator: Dinesh Shrikrishna, BSc, MRCP | |
| Principal Investigator: | Nicholas S Hopkinson, MRCP, PhD | Imperial College London |
More Information
Publications:
| Responsible Party: | Gary Roper, Imperial College London |
| ClinicalTrials.gov Identifier: | NCT01014338 History of Changes |
| Other Study ID Numbers: | P15099, ISRCTN05581879 |
| Study First Received: | November 16, 2009 |
| Last Updated: | June 22, 2011 |
| Health Authority: | United Kingdom: Medicines and Healthcare Products Regulatory Agency |
Additional relevant MeSH terms:
|
Lung Diseases Respiration Disorders Pulmonary Disease, Chronic Obstructive Muscle Weakness Paresis Lung Diseases, Obstructive Respiratory Tract Diseases Muscular Diseases Musculoskeletal Diseases Neuromuscular Manifestations Neurologic Manifestations Nervous System Diseases |
Pathologic Processes Signs and Symptoms Fosinopril Angiotensin-Converting Enzyme Inhibitors Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Antihypertensive Agents Cardiovascular Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on June 18, 2013