The Effect of High Dose N-acetylcysteine on Airtrapping and Airway Resistance in Chronic Obstructive Pulmonary Disease (COPD) Patients
Recruitment status was Recruiting
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Purpose
This study is to investigate the add-on effect of high dose NAC (600mg tablet twice daily) on reduction of airtrapping and airway resistance in stable COPD patients as well as to study it's effect in reducing exacerbation, improving exercise capacity and quality of life in stable COPD patients.
| Condition | Intervention | Phase |
|---|---|---|
|
COPD |
Drug: N-acetycysteine (600mg twice daily) Drug: Placebo |
Phase 4 |
| 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: | The Effect of High Dose N-acetylcysteine on Airtrapping and Airway Resistance of Chronic Obstructive Pulmonary disease-a Double Blinded Randomized Placebo Controlled Trial |
- Airtrapping in COPD patients [ Time Frame: At baseline (time 0 week) ] [ Designated as safety issue: No ]The airtrapping of COPD patients is measured by inspiratory capacity (IC), using plethsmography (MedGraphics Elite series)
- Airtrapping in COPD patients [ Time Frame: At 16th week ] [ Designated as safety issue: No ]The airtrapping of COPD patients is measured by inspiratory capacity (IC), using plethsmography (MedGraphics Elite series)
- Airtrapping in COPD patients [ Time Frame: At 52th Week ] [ Designated as safety issue: No ]The airtrapping of COPD patients is measured by inspiratory capacity (IC), using plethsmography (MedGraphics Elite series)
- Airway resistance in COPD patients [ Time Frame: At baseline ( time 0) ] [ Designated as safety issue: No ]Airway resistance is measured by plethsmography (Medgraphics Elite series) and impulse oscillometry.
- Airway resistance in COPD patients [ Time Frame: At 16th week ] [ Designated as safety issue: No ]Airway resistance is measured by plethsmography (Medgraphics Elite series) and impulse oscillometry.
- Airway resistance in COPD patients [ Time Frame: At 52th week ] [ Designated as safety issue: No ]Airway resistance is measured by plethsmography (Medgraphics Elite series) and impulse oscillometry.
- Exercise capacity [ Time Frame: At baseline ( time 0) ] [ Designated as safety issue: No ]Exercise capacity is measured by 6-min-walking distance (6MWD)and it is performed by a trained physiotherapist
- Exercise capacity [ Time Frame: At 16th week ] [ Designated as safety issue: No ]Exercise capacity is measured by 6-min-walking distance (6MWD)and it is performed by a trained physiotherapist
- Exercise capacity [ Time Frame: At 52th week ] [ Designated as safety issue: No ]Exercise capacity is measured by 6-min-walking distance (6MWD)and it is performed by a trained physiotherapist
- Quality of life [ Time Frame: At baseline (time 0) ] [ Designated as safety issue: No ]Quality of life is assessed by using the St Qeorge Respiratory Questionnaire (SQRQ)and it will be performed by a trained physiotherapist
- Quality of life [ Time Frame: At 16th week ] [ Designated as safety issue: No ]Quality of life is assessed by using the St Qeorge Respiratory Questionnaire (SQRQ)and it will be performed by a trained physiotherapist
- Quality of life [ Time Frame: At 52th week ] [ Designated as safety issue: No ]Quality of life is assessed by using the St Qeorge Respiratory Questionnaire (SQRQ)and it will be performed by a trained physiotherapist
- COPD exacerbation rate [ Time Frame: At 52th week ] [ Designated as safety issue: No ]The number of COPD exacerbation (exacerbation was defined as 2 out of 3 of the following criteria; 1.increase in shortness of breath, 2. increase in sputum purulence or 3. increase in sputum volume) will be assessed and documented
| Estimated Enrollment: | 120 |
| Study Start Date: | February 2010 |
| Estimated Study Completion Date: | September 2011 |
| Estimated Primary Completion Date: | September 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Placebo Comparator: Placebo
Placebo (600mg twice daily)
|
Drug: Placebo
Placebo (600mg twice daily)
|
|
Active Comparator: N-acetylcysteine
N-acetylcysteine (600mg twice daily)
|
Drug: N-acetycysteine (600mg twice daily)
N-acetycysteine (600mg twice daily) for one year
|
Detailed Description:
Background: The mucolytic and antioxidant effects of N-acetylcysteine (NAC) may be of great value in treatment of COPD patients. However, previous studies fail to demonstrate the beneficial effect of NAC. This may be due to insufficient dose of NAC used as well as inadequate outcome parameters measured in the past studies.
Objective of study: This study is to investigate the add-on effect of high dose NAC (600mg tablet twice daily) on reduction of airtrapping and airway resistance in stable COPD patients as well as to study it's effect in reducing exacerbation, improving exercise capacity and quality of life in stable COPD patients.
Study design: Randomized double blinded placebo controlled trial in Kwong Wah Hospital
Methodology: Patients are recruited in Kwong Wah Hospital if they fulfill the spirometric criteria of COPD. Eligible subjects will be randomized into the treatment (NAC 600mg tablet twice daily) and placebo group after completion of run in period. NAC and placebo will be prescribed accordingly in addition to their usual therapy. Both patients and investigators are blinded about the group allocation. Baseline assessment will be done and patients will be followed up at 16th weeks and 52th week of the study.
During each follow-up visit, hyperinflation parameters like inspiratory capacity (IC) will be measured by plethysmography. Airway resistance will be measured by both plethysmography and impulse oscillometry machine. Exercise capacity (6 min walking distance) and quality of life are also recorded during each follow up.
The difference of the above parameters between the 2 groups (drug and placebo group) will be analyszed by the Repeated measures ANOVA test
Eligibility| Ages Eligible for Study: | 40 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Spirometry diagnosed COPD with FEV1/FVC ratio less than 70% and FEV1 less than 80% predicted
- clinically stable and exacerbation free in the past 4 weeks
- history of at least one COPD exacerbation in the past one year
Exclusion Criteria:
- patients allergic or intolerant to NAC
- Recent use of NAC in the past one month
- history of asthma, non COPD respiratory disorders like bronchiectasis, pneumoconiosis or any active pulmonary infection
- patients on long term steroid
- patients on long term oxygen therapy or non invasive ventilation
Contacts and Locations| Contact: Hoi Nam Tse, MBChB | 852-92116036 | drhoinam@gmail.com |
| China | |
| Medical Department | Recruiting |
| Hong Kong, China | |
| Contact: Hoi Nam Tse, FHKAM, MBChB 852-92116036 drhoinam@gmail.com | |
| Principal Investigator: | Hoi Nam Tse, FHKAM, MBChB | Kwong Wah Hospital |
More Information
No publications provided
| Responsible Party: | Dr. Tse Hoi Nam, Kwong Wah Hospital |
| ClinicalTrials.gov Identifier: | NCT01136239 History of Changes |
| Other Study ID Numbers: | KW/EX/09-140, PR/CT 324/2009 |
| Study First Received: | June 1, 2010 |
| Last Updated: | June 2, 2010 |
| Health Authority: | Hong Kong: Department of Health United States: Food and Drug Administration |
Keywords provided by Kwong Wah Hospital:
|
COPD N-acetylcysteine airtrapping airway resistance antioxidant |
Additional relevant MeSH terms:
|
Lung Diseases Pulmonary Disease, Chronic Obstructive Lung Diseases, Obstructive Respiratory Tract Diseases Acetylcysteine N-monoacetylcystine Antiviral Agents Anti-Infective Agents Therapeutic Uses |
Pharmacologic Actions Expectorants Respiratory System Agents Free Radical Scavengers Antioxidants Molecular Mechanisms of Pharmacological Action Protective Agents Physiological Effects of Drugs Antidotes |
ClinicalTrials.gov processed this record on May 23, 2013