E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
Acute worsening of chronic obstructive lung disease |
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E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10010953 |
E.1.2 | Term | COPD exacerbation |
E.1.2 | System Organ Class | 100000004855 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To determine if titrated supplementary oxygen treatment to a low peripheral oxygen saturation initiated at arrival to the emergency department is superior to supplementary oxygen treatment titrated to a high peripheral oxygen saturation in reducing 30-day all-cause mortality in acutely admitted patients with COPD exacerbation. |
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E.2.2 | Secondary objectives of the trial |
To determine if supplementary oxygen titrated to a low peripheral oxygen saturation treatment initiated at arrival to the emergency department is superior to supplementary oxygen treatment titrated to a high peripheral oxygen saturation in acutely admitted patients with COPD exacerbation for,
- reducing 7-day all-cause mortality
- reducing need for non-invasive ventilation
- reducing need for intubation
- reducing intensive care admission
- reducing over-all length of hospital stay
- reducing the risk of respiratory acidosis
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Patients eligible for the trial must comply with the following at randomization:
1. age 18 years or older
2. ability to give informed consent
3. previously diagnosed COPD (either confirmed diagnosis at prior hospital contact or from their general practitioner or confirmed diagnosis by the treating physician in the emergency department (verified by use of relevant medication))
4. admitted with acute exacerbation (acute and worsened shortness of breath) of COPD
5. requiring oxygen treatment
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E.4 | Principal exclusion criteria |
1. Instability at arrival requiring immediate lifesaving treatment, e.g. intubation or non-invasive ventilation, within the first 30 minutes
2. Expected total length of stay in hospital < 12 hours
3. Planned transfer to another hospital within 12 hours
4. Unwilling to have repeated arterial blood gas analyses within the first 12 hours
5. Patients judged terminal by treating physician in the emergency department
6. Non-residents of the particular country
7. Expected impossible follow-up
8. Fertile women (<50 years of age) with positive urine human gonadotropin (hCG) or plasma-hCG
9. Prior participation in the study
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary outcome is 30-day all-cause mortality extracted from the Danish national registries. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
30 days after end of trial |
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E.5.2 | Secondary end point(s) |
- 7-day all-cause mortality extracted from the Danish national registries
- non-invasive ventilation extracted from the hospital records
- intubation extracted from the hospital records
- intensive care admission extracted from the hospital records
- over-all length of hospital stay calculated from the hospital records
- respiratory acidosis (measured as an arterial blood gas analysis with pH < 7.35 and hypercapnia)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
During admission and 7 days after end of trial |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
Comparator is same medicinal gas (drug) - but different dose |
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E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 4 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 4 |
E.8.9.1 | In the Member State concerned days | 0 |