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Trial registered on ANZCTR
Registration number
ACTRN12617001635358
Ethics application status
Approved
Date submitted
24/11/2017
Date registered
18/12/2017
Date last updated
18/12/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Safety of beta blocker in acute exacerbations of chronic obstructive pulmonary disease (COPD)
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Scientific title
Safety of beta blocker commencement during acute exacerbations of chronic obstructive pulmonary disease (COPD) in patients with co-existing cardiovascular disease.
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Secondary ID [1]
293436
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None
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Universal Trial Number (UTN)
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Trial acronym
COPD
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic Obstructive Pulmonary Disease
305606
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Cardiovascular disease
305607
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Condition category
Condition code
Respiratory
304827
304827
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0
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Chronic obstructive pulmonary disease
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Cardiovascular
304828
304828
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
All COPD patients who fulfil the inclusion criteria will be given oral metoprolol (ATC C07A B02) 25mg daily for 21 days.
Patients will be assessed on Day 0, 1 and 21 for any side effects from oral metoprolol as well as the effect of metoprolol on spirometry.
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Intervention code [1]
299678
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Treatment: Drugs
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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To assess the safety of commencement of metoprolol in patients admitted with exacerbation of COPD with co-existing cardiovascular diseases, as defined by any adverse events,
Known adverse events from beta blocker includes hypotension, bradycardia, and bronchospasm.
Patients will be monitored for possible adverse events on day 0, 1 and 21 by performing spirometry as well as completion of a St George's Respiratory Questionnaire (SGRQ).
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Assessment method [1]
304036
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Timepoint [1]
304036
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Baseline, Day 1 and Day 21 post metoprolol commencement.
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Secondary outcome [1]
340776
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To assess the impact of commencement of metoprolol on lung function as measured by post bronchodilator spirometry in patients admitted for exacerbation of COPD.
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Assessment method [1]
340776
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Timepoint [1]
340776
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Baseline, Day 1 and Day 21 post commencement of metoprolol.
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Eligibility
Key inclusion criteria
- Age over 18 years
- Primary admission diagnosis of acute exacerbation of COPD
- Moderate to severe COPD (GOLD Class II – III) as defined by spirometry performed prior to admission
- Co-existing cardiovascular diseases with Class I indications, such as IHD, HTN and HFrEF for which beta blocker therapy is indicated.
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Minimum age
18
Years
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Maximum age
85
Years
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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
- Unwilling to consent
- History of other primary lung disease including asthma, and interstitial lung disease
- Baseline FEV1/FVC greater than 0.7
- Very severe COPD (GOLD IV)
- Illness severity, sufficient to preclude informed consent or completion of the study protocol. Subjects are also excluded if enrolment in the study protocol was likely to interfere with timely medical investigation and treatment
- Severe cognitive impairment
- Physical impairment or social circumstances that would prevent follow up assessments
- Patients with beta blocker allergy or previous documented reactions
- Any degree of heart block
- Already taking a beta blocker or other anti-arrhythmic including calcium channel blocker
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
Paired t-test will be used to examine impact of beta blocker administration on spirometric results.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/01/2018
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Actual
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Date of last participant enrolment
Anticipated
30/06/2018
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Actual
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Date of last data collection
Anticipated
23/07/2018
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
9430
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The Northern Hospital - Epping
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Recruitment hospital [2]
9431
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Austin Health - Austin Hospital - Heidelberg
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Recruitment postcode(s) [1]
18140
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3076 - Epping
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Recruitment postcode(s) [2]
18141
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3084 - Heidelberg
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Funding & Sponsors
Funding source category [1]
298066
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Hospital
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Name [1]
298066
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Northern Hospital
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Address [1]
298066
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185 Cooper Street
EPPING 3076
VIC
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Country [1]
298066
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Australia
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Primary sponsor type
Hospital
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Name
Northern Hospital
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Address
185 Cooper Street
EPPING 3076
VIC
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Country
Australia
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Secondary sponsor category [1]
297142
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None
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Name [1]
297142
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None
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Address [1]
297142
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None
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Country [1]
297142
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299082
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Austin HREC
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Ethics committee address [1]
299082
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145 Studley Road HEIDELBERG 3084 VIC
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Ethics committee country [1]
299082
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Australia
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Date submitted for ethics approval [1]
299082
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02/08/2017
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Approval date [1]
299082
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09/10/2017
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Ethics approval number [1]
299082
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HREC/17/Austin/321
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Summary
Brief summary
Cardiovascular comorbidity is common in patients with COPD. They share cigarette smoking as an important risk factor. However, beta blockers, which are commonly used to treat cardiac diseases, are traditionally avoided in patients with COPD due to the theoretical risk of respiratory adverse events. The aims of this study are: 1. To assess the safety of commencing beta blockers during an acute exacerbation of COPD in individuals with coexistent cardiovascular disease. 2. To assess the impact of commencement of beta blockers on lung function as measure by post bronchodilator spirometry in patients admitted for exacerbation of COPD. This is a prospective interventional study of individuals admitted with exacerbations of COPD conducted in two metropolitan hospitals in Melbourne. Individuals who are admitted to the Northern and Austin Hospital with acute exacerbations of COPD who have a history of COPD (GOLD Class II – III) and of cardiovascular disease will be invited to participate in the study. When they are considered stable and suitable for participation, the treating team will notify the study coordinator who will consent and enroll the individual in the study. After signing of the informed consent form, participants who are identified to be ready for discharge the following day will perform spirometry. An initial dose of a cardio-selective beta blocker will be administered and spirometry will be repeated. Unless an adverse event has occurred, beta blocker administration will continue on the day of discharge, with spirometry repeated. Participants will be reviewed at 21-days post discharge with repeat spirometry. This will be carried out in the Respiratory Outpatient Clinic as is standard practice.
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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
79238
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Dr Katharine See
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Address
79238
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Northern Health
185 Cooper Street
EPPING 3076
VIC
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Country
79238
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Australia
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Phone
79238
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+613 8405 8000
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Fax
79238
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Email
79238
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[email protected]
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Contact person for public queries
Name
79239
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Katharine See
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Address
79239
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Northern Health
185 Cooper Street
EPPING 3076
VIC
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Country
79239
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Australia
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Phone
79239
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+613 8405 8000
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Fax
79239
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Email
79239
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[email protected]
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Contact person for scientific queries
Name
79240
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Katharine See
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Address
79240
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Northern Health
185 Cooper Street
EPPING 3076
VIC
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Country
79240
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Australia
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Phone
79240
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+613 8405 8000
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Fax
79240
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Email
79240
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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
Source
Title
Year of Publication
DOI
Dimensions AI
Author reply
2018
https://doi.org/10.1111/imj.13700
N.B. These documents automatically identified may not have been verified by the study sponsor.
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