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Trial registered on ANZCTR
Registration number
ACTRN12605000014651
Ethics application status
Approved
Date submitted
12/07/2005
Date registered
18/07/2005
Date last updated
18/07/2005
Type of registration
Prospectively registered
Titles & IDs
Public title
Acute Exacerbations of COPD: Role of Short Course Steroids
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Scientific title
A randomised double blind study of short course systemic steroids versus conventional 14 days course in acute exacerbations of COPD
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic Obstructive Pulmonary Disease (COPD)
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Condition category
Condition code
Respiratory
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Chronic obstructive pulmonary disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Prednisolone 0.5mg/Kg for 14 days
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
Prednisolone of 1 mg/kg for 3days (max 50 mg)+ 11 day placebo
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Length of stay in hospital
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Assessment method [1]
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Timepoint [1]
120
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Secondary outcome [1]
279
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Rate of treatment failure
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Assessment method [1]
279
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Timepoint [1]
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Rebound exacerbation over the one month period following cessation of short course versus conventional corticosteroid treatment.
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Secondary outcome [2]
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Symptom score
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Assessment method [2]
280
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Timepoint [2]
280
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Secondary outcome [3]
281
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Lung function tests
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Assessment method [3]
281
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Timepoint [3]
281
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Secondary outcome [4]
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Sputum cellularity
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Assessment method [4]
282
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Timepoint [4]
282
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Eligibility
Key inclusion criteria
All patients admitted to the Royal Hobart Hospital with the primary diagnosis of Acute exacerbation of COPD
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1 Patients who have already received more than one oral CS dose from their GP prior to presentation, or who have received a treatment CS course within the past one-month will not be eligible. 2 Patients on long-term oral CS at a dose of greater than 5 mg/day. 3 Significant co-morbidities such as on-going angina or current cardiac failure 4 Pneumonic consolidation, lung cancer, fibrosis, bronchiectasis or asthma.5 Inability to comply with instructions.6 Patients with inadequate social supports - these patients often have prolonged admissions once the acute phase has resolved ICS begun before admission will not be an exclusion criterion, but will be taken into account in a subgroup analysisexacerbation of COPD
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
randomisation
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Julian date
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
7/07/2007
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
200
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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School of Medicine, University of Tasmania
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Address [1]
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Country [1]
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Australia
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Funding source category [2]
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Government body
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Name [2]
128
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Applied for National Health & Medical Research Council funding
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Address [2]
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Country [2]
128
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Australia
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Primary sponsor type
University
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Name
UTas
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Address
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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School of Medicine
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Address [1]
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
884
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Southern tasmanian ethics commitee
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Ethics committee address [1]
884
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Ethics committee country [1]
884
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Australia
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Date submitted for ethics approval [1]
884
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Approval date [1]
884
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Ethics approval number [1]
884
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H8356
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Summary
Brief summary
The OVERALL AIM of this project is to build on our recent demonstration that the reduction in airway inflammation following introduction of systemic corticosteroids (CS) during acute exacerbations of COPD (AECOPD) is rapid and significant at 48 hours. We will now compare two CS treatment regimens: short course (72 hours only) of high dose versus more conventional, moderate dose therapy over 14 days in terms of efficacy and adverse events (AE). At the same time, we will continue our work to delineate the aetiological factors and inflammatory processes underlying AECOPD. This project will test the following hypotheses: 1 Systemic CS are effective during AECOPD because of a rapid reduction in neutrophil chemotactic cytokines and down-regulation of neutrophil-related vascular adhesion molecules; this occurs over the first 2-3 days of therapy. 2. Thus, short-course, high-dose CS therapy is as efficacious in the treatment of AECOPD as a more conventional 14-day course of moderate dose CS, but with significantly less risk of AE and without rebound of inflammation after cessation. Hospital length of stay can be reduced. 3.Exacerbations over the subsequent one month (treatment failure) are no more frequent with short versus conventional course CS therapy. 4. Viral and bacterial organisms isolated from sputum during an AECOPD are associated with a greater inflammatory response within the airway than non-infective exacerbations, but both are responsive to CS therapy. Specific aims are: 1.To build on our preliminary findings of a rapid reduction in sputum neutrophilia and improvement in symptoms by systemic CS during AECOPD and to examine whether this relates to inhibition of neutrophil-related chemotactic factors and vascular adhesion molecules. 2.To compare short-course (3 day), high dose CS treatment and more conventional 14-day moderate dose CS therapy with focus on clinical outcomes, reductions in airway inflammation, rebound exacerbation and adverse events. 3.To identify bacterial and viral organisms as well as determine bacterial load at admission and to then relate these to airway inflammation, response to treatment and rate of rebound.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr David Reid
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Address
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Clinical School of Medicine
43 Collins Street
Hobart TAS 7001
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Country
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Australia
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Phone
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+61 3 62267043
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Fax
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+61 3 62264894
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Himanshu Garg
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Address
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Clinical School of Medicine
43 Collins Street
Hobart TAS 7001
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Country
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Australia
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Phone
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+61 3 62264846
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Fax
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+61 3 62264894
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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