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Chronic Obstructive Pulmonary DiseasePPR-NHFNCT03882372

Nasal High Flow to Maintain the Benefits of Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease Patients

A study testing Nasal high flow in people with Chronic Obstructive Pulmonary Disease, run by ADIR Association at 1 site in France.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Chronic obstructive pulmonary disease (COPD) is a major cause of disability and mortality worldwide. This systemic disease progressively leads to dyspnea and exercise capacity impairment. Pulmonary rehabilitation effectively improves exercise capacity, dyspnea and quality of life in patients with COPD. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Chronic Obstructive Pulmonary Disease
What is being tested?
Nasal high flow
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2 participants
Where
1 siteFrance
Study dates
22 Jul 2019to 1 Sep 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Chronic obstructive pulmonary disease stage III to IV;
  • With or without long-term oxygen therapy;
  • Having completed a course of pulmonary rehabilitation within the last 4 weeks (at least 18 sessions).

Who cannot join

  • Did not complete a course of pulmonary rehabilitation;
  • Using noninvasive ventilation or constant positive airway pressure treatment;
  • Tracheostomy;
  • Nasal high flow intolerance;
  • Pregnancy or likely to be;
  • Unable to consent;
  • Patients under guardianship.

Trial locations and contacts

1 site in 1 country.

France1 site
  • ADIR Association

    Bois-Guillaume, 76230

Other trials in France

About this study

Official title: Nasal High Flow to Maintain the Benefits of Pulmonary Rehabilitation in Patients With Severe to Very Severe Chronic Obstructive Pulmonary Disease - A Randomized Controlled Study

Chronic obstructive pulmonary disease (COPD) is a major cause of disability and mortality worldwide. This systemic disease progressively leads to dyspnea and exercise capacity impairment. Pulmonary rehabilitation effectively improves exercise capacity, dyspnea and quality of life in patients with COPD. However, its benefits progressively fade over time due to several factors such as the lack of regular exercise activity, dyspnea, airway secretions, hematosis impairment and acute exacerbations which can lead to hospitalization and accelerated muscle wasting.

Nasal high flow (NHF) is a support used to deliver heated and humidified high flow air (up to 60 L/min) through nasal canula providing promising physiological benefits such as positive airway pressure or upper airway carbon dioxide washout. It can be used in association with oxygen and offers the advantage to overtake the patient's inspiratory flow, providing a stable inspired fraction of oxygen. Nasal high flow has widely been studied in pediatric and adult intensive care units and seems better than conventional oxygen therapy and as effective as noninvasive ventilation with regards to mortality to treat hypoxemic acute respiratory failure.

Read more

More recently, several studies have shown that long-term nasal high flow could contribute to improve exercise capacity, dyspnea, airway secretion removal, hematosis, reduced acute exacerbations and subsequent hospitalizations in patients with COPD.

Based on these results, the primary aim of this study is to assess whether long-term nasal high flow treatment can help COPD patients to better maintain their endurance capacity following a course of pulmonary rehabilitation.

Read the detailed description

Experimental design:

Patients achieving their last pulmonary rehabilitation session will be approached to participate in this study.

Eligible patients who agree to participate in the study and sign informed consent will perform two baseline visit assessments:

First visit: Incremental cardiopulmonary exercise testing. Second visit: Other baseline assessment (see outcome section), including a constant workload exercise testing at 75% of the maximal workload achieved during the incremental exercise testing.

Then, patients will then be randomized to one of the following two arms:

  • Nasal high flow,
  • Usual care.

After 6 months, patients will be invited to perform the same assessment as during the second baseline visit.

Being tested
Nasal high flow
Keywords
Chronic obstructive pulmonary disease, Pulmonary rehabilitation, Nasal high flow
Medical subject headings
Pulmonary Disease, Chronic Obstructive

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Nasal high flowDevice

    See arm description.

Study groups in NCT03882372
Study groupRoleWhat they receive
Nasal high flowExperimentalFollowing baseline assessment, patients randomized to the nasal high flow arm will be equipped with a nasal high flow device (myAIRVO2) administrated through the Optiflow nasal canula. Flow will be set at the highest flow tolerated (20-30 L/min): initially 30 L/min, progressively decrease if not tolerated. Temperature will be set between 34-37°C according to the tolerance : initially 37°C and decreased if not tolerated. Patients will be asked to use the device 8h per day. Patients under long-term oxygen will preserve their usual flow. The usual prescribed oxygen flow will then be titrated during nasal high flow to maintain the same baseline transcutaneous oxygen saturation as their conventional oxygen therapy (≥ 90%) to prevent any oxygen dilution effect of nasal high flow.
Receives: Device: Nasal high flow
Usual careNo interventionPatient randomized to the control group will have no other specific intervention than their usual care. Patients under long-term oxygen will preserve their usual flow.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Endurance capacity

    Patients will perform a constant workload exercise testing at 75% of the maximal workload achieved during the incremental cardiopulmonary exercise testing.

    Measured: The endurance capacity will be assessed at baseline

  2. Endurance capacity

    Patients will perform a constant workload exercise testing at 75% of the maximal workload achieved during the incremental cardiopulmonary exercise testing.

    Measured: The endurance capacity will be assessed post-intervention (after 6months)

Secondary outcomes (29)
  1. Quality of life: Saint George's Respiratory Questionnaire

    Quality of life will be assessed using the Saint George's Respiratory Questionnaire. The score range from 0 (worst quality of life) to 100 (optimal quality of life).

    Measured: The quality of life will be assessed at baseline

  2. Quality of life: Saint George's Respiratory Questionnaire

    Quality of life will be assessed using the Saint George's Respiratory Questionnaire. The score range from 0 (worst quality of life) to 100 (optimal quality of life).

    Measured: The quality of life will be assessed at post-intervention (after 6months)

  3. Quality of life: Chronic Obstructive Pulmonary Disease Assessement Test

    Quality of life will be assessed using the Chronic Obstructive Pulmonary Disease Assessement Test

    Measured: The quality of life will be assessed at baseline and post-intervention for a total time frame of 6month

  4. Quality of life: Chronic Obstructive Pulmonary Disease Assessement Test

    Quality of life will be assessed using the Chronic Obstructive Pulmonary Disease Assessement Test

    Measured: The quality of life will be assessed post-intervention (after 6months)

  5. Exacerbations

    The number of chronic obstructive pulmonary disease self reported exacerbations experienced by the participants during the 6 months period of follow-up will be assessed.

    Measured: The number of exacerbations will be assessed for a total time frame of 6month

  6. Hospitalizations

    The number of chronic obstructive pulmonary disease related hospitalizations experienced by the participants during the 6 months period of follow-up will be assessed.

    Measured: The number of hospitalizations will be assessed for a total time frame of 6month

  7. Muscle function (1) : quadriceps muscle (rectus femoris) cross-sectional area

    The quadriceps muscle thickness will be assessed using echographies.

    Measured: The quadriceps muscle thickness will be assessed at baseline

  8. Muscle function (1) : quadriceps muscle (rectus femoris) cross-sectional area

    The quadriceps muscle thickness will be assessed using echographies.

    Measured: The quadriceps muscle thickness will be assessed at baseline and post-intervention for a total time frame of 6month

  9. Muscle function (2) : bioimpedance

    The overall muscle function will be assessed using bioimpedance (free fat mass minus total body water)

    Measured: The overall muscle function using bioimpedance will be assessed post-intervention (after 6months)

  10. Exercise capacity

    Exercise capacity will be assessed using the six minutes walk test distance.

    Measured: The distance performed during the six-minute walk test will be assessed at baseline

  11. Exercise capacity

    Exercise capacity will be assessed using the six minutes walk test distance.

    Measured: The distance performed during the six-minute walk test will be assessed post-intervention (after 6months)

  12. Respiratory muscle function (1) : maximal inspiratory pressure

    Measured: Maximal inspiratory pressure will be assessed at baseline

  13. Respiratory muscle function (1) : maximal inspiratory pressure

    Measured: Maximal inspiratory pressure will be assessed post-intervention (after 6months)

  14. Respiratory muscle function (2) : maximal expiratory pressure

    Measured: Maximal expiratory pressure will be assessed at baseline

  15. Respiratory muscle function (2) : maximal expiratory pressure

    Measured: Maximal expiratory pressure will be assessed post-intervention (after 6months)

  16. Respiratory muscle function (3) : sniff test

    Measured: Sniff test will be assessed at baseline

  17. Respiratory muscle function (3) : sniff test

    Measured: Sniff test will be assessed post-intervention (after 6months)

  18. Parasternal electromyogram

    Parasternal electromyogram will be used to assess central output during maximal inspiratory and expiratory pressure measurement as during the sniff test. Moreover, parasternal electromyogram will be assessed both at rest and during nasal high flow (30L/min, 34°C).

    Measured: Parasternal electromyogram will be assessed at baseline

  19. Parasternal electromyogram

    Parasternal electromyogram will be used to assess central output during maximal inspiratory and expiratory pressure measurement as during the sniff test. Moreover, parasternal electromyogram will be assessed both at rest and during nasal high flow (30L/min, 34°C).

    Measured: Parasternal electromyogram will be assessed post-intervention (after 6months)

  20. Physical activity (1) : steps per day

    The number of steps per day will be recorded over a course of 14 week days using an activity monitor.

    Measured: Steps per day will be assessed during 14 days following inclusion

  21. Physical activity (1) : steps per day

    The number of steps per day will be recorded over a course of 14 week days using an activity monitor.

    Measured: Steps per day will be assessed during 14 days after 6months of intervention

  22. Physical activity (2) : time spent during activities superior to 3 metabolic equivalent per day

    The time spent during activities superior to 3 metabolic equivalent per day will be over a course of 14 week days

    Measured: The time spent during activities superior to 3 metabolic equivalent per day will be assessed 14 days following inclusion

  23. Physical activity (2) : time spent during activities superior to 3 metabolic equivalent per day

    The time spent during activities superior to 3 metabolic equivalent per day will be over a course of 14 week days

    Measured: The time spent during activities superior to 3 metabolic equivalent per day will be assessed during 14 days after 6months of intervention

  24. Quality of sleep (1) : Visual Analogue Scale

    The quality of sleep will be assessed using a aVisual Analogue Scale (ranging from 0 to 10 with 10 indicating higher sleep quality).

    Measured: The quality of sleep using a Visual Analogue Scale will be assessed at baseline

  25. Quality of sleep (1) : Visual Analogue Scale

    The quality of sleep will be assessed using a aVisual Analogue Scale (ranging from 0 to 10 with 10 indicating higher sleep quality).

    Measured: The quality of sleep using a Visual Analogue Scale will be assessed post-intervention (after 6months)

  26. Quality of sleep (2) : pittsburgh scale

    The quality of sleep will be assessed using the pittsburgh scale which has been validated to assess sleep quality. The scale range from 0 (major sleep difficulties) to 21 (no difficulty).

    Measured: The quality of sleep using the pittsburgh scale will be assessed at baseline

  27. Quality of sleep (2) : pittsburgh scale

    The quality of sleep will be assessed using the pittsburgh scale which has been validated to assess sleep quality. The scale range from 0 (major sleep difficulties) to 21 (no difficulty).

    Measured: The quality of sleep using the pittsburgh scale will be assessed post-intervention (after 6months)

  28. Adherence to treatment : days of utilization during the follow-up

    The data will be retrieved from the nasal high flow device

    Measured: The number of days that the nasal high flow device was used throughout the follow-up will be assessed post-intervention in the nasal high flow arm for a total time frame of 6 months

  29. Adherence to treatment : hours of utilization per day

    The data will be retrieved from the nasal high flow device

    Measured: The number of hours of utilization per day throughout the follow-up will be assessed post-intervention in the nasal high flow arm for a total time frame of 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Mar 2019
  2. Study start22 Jul 2019
  3. Primary completion1 Sep 2023
  4. Study completion1 Sep 2023

Why it stopped: Recruitment failure

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Single blind randomized study.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
2 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03882372
Sponsor's protocol ID
PPR-NHF
Acronym
PPR-NHF
Status last verified
Nov 2023
First submitted
18 Mar 2019
Last updated
15 Nov 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Nasal high flow in people with Chronic Obstructive Pulmonary Disease, run by ADIR Association at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 15 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: Recruitment failure). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Endurance capacity (time frame: The endurance capacity will be assessed at baseline). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Nov 2023.

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