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A multi-center randomized, controlled, open-label trial evaluating the effects of eosinophil-guided corticosteroid-sparing therapy in hospitalised patients with COPD exacerbations - The CORTICO steroid reduction in COPD (CORTICO-COP) study protocol.
- Source :
- BMC Pulmonary Medicine; 8/15/2017, Vol. 17, p1-7, 7p, 1 Diagram, 1 Chart
- Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>The most commonly applied treatment for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is a 5-day course of high-dose systemic corticosteroids. However, this treatment has not been shown to reduce mortality and can potentially have serious side effects. Recent research has shown that, presumably, only a subgroup of COPD patients identifieable by blood eosinophil count benefit from a rescue course of prednisolone. By applying a biomarker-guided strategy, the aim of this study is to determine whether it is possible to reduce the use of systemic corticosteroids in AECOPD without influencing the outcome.<bold>Methods: </bold>This is an ongoing prospective multicenter randomized controlled open label trial comprising 320 patients with AECOPD recruited from four hospitals in Denmark. The patients are randomized 1:1 to either standard care or eosinophil-guided corticosteroid-sparing therapy where prednisolone is not administered if the daily blood sampling reveals an eosinophil level below 0.3 × 109 cells/L. The primary endpoint is length of hospital stay within 14 days after recruitment. The secondary endpoints are treatment failure, 30-day mortality rate, COPD related re-admission rate, change in FEV1, and a number of adverse effect measures obtained within 3 months after the index hospitalisation date related to corticosteroid usage.<bold>Discussion: </bold>This will be a very large RCT providing knowledge about the effectiveness of individualized biomarker-guided corticosteroid therapy in hospitalised patients with AECOPD.<bold>Trial Registration: </bold>Clinicaltrials.gov, NCT02857842 , 02-august-2016. Clinicaltrialregister.eu: Classification Code: 10,010,953, 02-marts-2016. [ABSTRACT FROM AUTHOR]
- Subjects :
- EOSINOPHILS
EOSINOPHILIA
STEROID receptors
CORTICOSTEROIDS
HORMONE therapy
OBSTRUCTIVE lung disease treatment
PHYSIOLOGY
THERAPEUTICS
THERAPEUTIC use of glucocorticoids
PREDNISOLONE
COMPARATIVE studies
HOSPITAL care
LENGTH of stay in hospitals
OBSTRUCTIVE lung diseases
RESEARCH methodology
MEDICAL cooperation
RESEARCH protocols
MORTALITY
RESEARCH
EVALUATION research
RANDOMIZED controlled trials
TREATMENT effectiveness
DISEASE progression
PATIENT readmissions
LEUKOCYTE count
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 14712466
- Volume :
- 17
- Database :
- Complementary Index
- Journal :
- BMC Pulmonary Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 124671246
- Full Text :
- https://doi.org/10.1186/s12890-017-0458-7