HemoptysisARTEMHYSNCT01278199
Bronchial Artery Embolization and Medical Measures in Non Severe Acute Hemoptysis of Mild-moderate Abundance
A study testing Medicals measures and bronchial artery embolization in people with Hemoptysis and Acute Disease, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.
Trial summary
Severe hemoptysis is a life-threatening condition, with an unpredictable course. The efficacy of bronchial artery embolization (BAE) is well established for the treatment of severe hemoptysis, with short and long-term bleeding controls obtained in 70 to 100% and 50 to 90% of cases, respectively. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hemoptysis, Acute Disease
- What is being tested?
- Medicals measures and bronchial artery embolization
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 73 participants
- Where
- 1 siteFrance
- Study dates
- Nov 2011to 27 Feb 2017
- 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Non-severe acute hemoptysis (mild-to-moderate abundance and no criteria of severity).
- Age > 18 years
- Patients with social insurance
Who cannot join
- Pregnant and/or lactating women
- Traumatic hemoptysis
- Severe hemoptysis (volume > 200 ml; respiratory failure; hemodynamic instability)
- Patients already enrolled in the study within the preceding 3 months
- Patients in palliative care, for whom there is no therapeutic plan at short-term
- Moribund patients
Trial locations and contacts
1 site in 1 country.
About this study
Official title: A Multicentric Randomized Trial Comparing the Bronchial Artery Embolization Combined With Medical Measures and the Medical Measures Alone in the Treatment of Non-severe Acute Hemoptysis of Mild-to-moderate Abundance
Severe hemoptysis is a life-threatening condition, with an unpredictable course. The efficacy of bronchial artery embolization (BAE) is well established for the treatment of severe hemoptysis, with short and long-term bleeding controls obtained in 70 to 100% and 50 to 90% of cases, respectively. As complications related to vascular interventional radiology may occur in 5 to 10% of cases, the benefit-risk balance might be less clear in acute hemoptysis of mild-to-moderate abundance (volume between 100 and 200 ml) and no criteria of severity (respiratory failure or hemodynamic instability). There is no available data comparing the safety and efficacy of BAE combined with medical measures to those of medical measures alone in the treatment of non-severe acute hemoptysis of mild-to-moderate abundance.
Read the detailed description
The study is a multicentric (n=8) randomized study, involving two parallel groups of patients with non-severe acute hemoptysis of mild-to-moderate abundance, related to a systemic bronchial or non-bronchial hypervascularization, and comparing the bronchial artery embolization combined with medical measures and the medical measures alone in this field.
The primary aim of the study is to evaluate the efficacy of BAE combined with medical measures in the treatment of non-severe acute hemoptysis of mild-to-moderate abundance, as compared with that of medical measures alone, by assessing the percentage of recurrence of hemoptysis at one month. Bleeding recurrence is defined as a volume of blood expectorated of at least 50 ml.
The second objectives of the study are to compare the efficacy of the two strategies at 3 months and to assess the safety of both strategies during hospitalization and follow-up.
Based on a previous study of our group (Reference 8), the number of patients in each group is 105, assuming a one-month bleeding recurrence rate of 11% in the group receiving BAE, as compared with 26% in the group assisted medically (a=.05; β=0.8).
- Conditions
- Hemoptysis, Acute Disease
- Being tested
- Medicals measures, bronchial artery embolization
- Keywords
- Bronchial Artery Embolization, Non-severe Hemoptysis, Bleeding mild-to-moderate abundance, Volume ranging from 100 ml to 200 ml
- Medical subject headings
- Hemoptysis, Acute Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Medicals measuresOther
Rest in bed. Monitoring of respiratory frequency. Fixation of intravenous route. Administration of nasal oxygenotherapy in order to maintain SpO2 > 90%. Administration of antituberculosis treatment, in case with active pulmonary tuberculosis known at admission or diagnosed during the stay.
If necessary a bronchial wash out of will be realized by a bronchial fibroscopy with measures of use of cold serum, adrenalin xylocain or terlipressin.
The administration of antibiotherapy by general mode according to the clinician appreciation.
The administration of terlipressin according to the clinician appreciation. Against the cough treatment administration according to the clinician appreciation.
bronchial artery embolizationOther
The bronchial artery embolization is practised within 48 hours which follow the hospital admission for non-severe acute hemoptysis.
| Study group | Role | What they receive |
|---|---|---|
| 2 | Other | Medicals measures in the treatment of non-severe acute hemoptysis Receives: Other: Medicals measures |
| 1 | Experimental | bronchial artery embolization (BAE) Receives: Other: bronchial artery embolization |
What is being measured
The primary outcome is the main question the study is designed to answer.
Bleeding recurrence rate, after initial therapeutic strategy.
Bleeding recurrence is defined as a volume of expectorated blood of 50 ml or more.
Measured: One month
Secondary outcomes (1)
Evaluation of the rate of serious adverse events
Evaluation of the rate of serious adverse events, according to the therapeutic strategy during hospitalization and follow-up period
Measured: 3 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Jan 2011 (estimated)
- Study startNov 2011
- Primary completion27 Dec 2016
- Study completion27 Feb 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (41)Papers the sponsor has linked to this study.
- Other trials for HemoptysisStudies of the same condition, open and under way.
- More trials run by Assistance Publique - Hôpitaux de ParisThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 73 participants (actual)
Sponsor and investigators
- Lead sponsor
- Assistance Publique - Hôpitaux de Paris
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Muriel FARTOUKH, MD, Principal investigator, Tenon Hospital, AP-HP
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01278199
- Sponsor's protocol ID
- K081202
- Acronym
- ARTEMHYS
- Status last verified
- Mar 2017
- First submitted
- 14 Jan 2011
- Last updated
- 22 Mar 2017
- Results posted
- No
- Data monitoring committee
- No
Publications
Mal H, Rullon I, Mellot F, Brugiere O, Sleiman C, Menu Y, Fournier M. Immediate and long-term results of bronchial artery embolization for life-threatening hemoptysis. Chest. 1999 Apr;115(4):996-1001. doi: 10.1378/chest.115.4.996.
PubMed 10208199PURSEL SE, LINDSKOG GE. Hemoptysis. A clinical evaluation of 105 patients examined consecutively on a thoracic surgical service. Am Rev Respir Dis. 1961 Sep;84:329-36. doi: 10.1164/arrd.1961.84.3.329. No abstract available.
PubMed 13738524Hirshberg B, Biran I, Glazer M, Kramer MR. Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital. Chest. 1997 Aug;112(2):440-4. doi: 10.1378/chest.112.2.440.
PubMed 9266882Revel MP, Fournier LS, Hennebicque AS, Cuenod CA, Meyer G, Reynaud P, Frija G. Can CT replace bronchoscopy in the detection of the site and cause of bleeding in patients with large or massive hemoptysis? AJR Am J Roentgenol. 2002 Nov;179(5):1217-24. doi: 10.2214/ajr.179.5.1791217.
PubMed 12388502Mal H. [Role of surgery in the management of severe haemoptysis]. Rev Mal Respir. 2005 Nov;22(5 Pt 1):717-9. doi: 10.1016/s0761-8425(05)85627-x. No abstract available. French.
PubMed 16272972Picard C, Parrot A, Boussaud V, Lavole A, Saidi F, Mayaud C, Carette MF. Massive hemoptysis due to Rasmussen aneurysm: detection with helicoidal CT angiography and successful steel coil embolization. Intensive Care Med. 2003 Oct;29(10):1837-9. doi: 10.1007/s00134-003-1912-y. Epub 2003 Sep 13.
PubMed 13680121Remy J, Lemaitre L, Lafitte JJ, Vilain MO, Saint Michel J, Steenhouwer F. Massive hemoptysis of pulmonary arterial origin: diagnosis and treatment. AJR Am J Roentgenol. 1984 Nov;143(5):963-9. doi: 10.2214/ajr.143.5.963.
PubMed 6333165Fartoukh M, Khalil A, Louis L, Carette MF, Bazelly B, Cadranel J, Mayaud C, Parrot A. An integrated approach to diagnosis and management of severe haemoptysis in patients admitted to the intensive care unit: a case series from a referral centre. Respir Res. 2007 Feb 15;8(1):11. doi: 10.1186/1465-9921-8-11.
PubMed 17302979Savale L, Parrot A, Khalil A, Antoine M, Theodore J, Carette MF, Mayaud C, Fartoukh M. Cryptogenic hemoptysis: from a benign to a life-threatening pathologic vascular condition. Am J Respir Crit Care Med. 2007 Jun 1;175(11):1181-5. doi: 10.1164/rccm.200609-1362OC. Epub 2007 Mar 1.
PubMed 17332480Bruzzi JF, Remy-Jardin M, Delhaye D, Teisseire A, Khalil C, Remy J. Multi-detector row CT of hemoptysis. Radiographics. 2006 Jan-Feb;26(1):3-22. doi: 10.1148/rg.261045726.
PubMed 16418239Khalil A, Parrot A, Nedelcu C, Fartoukh M, Marsault C, Carette MF. Severe hemoptysis of pulmonary arterial origin: signs and role of multidetector row CT angiography. Chest. 2008 Jan;133(1):212-9. doi: 10.1378/chest.07-1159. Epub 2007 Nov 7.
PubMed 17989162Dweik RA, Stoller JK. Role of bronchoscopy in massive hemoptysis. Clin Chest Med. 1999 Mar;20(1):89-105. doi: 10.1016/s0272-5231(05)70129-5.
PubMed 10205720Crocco JA, Rooney JJ, Fankushen DS, DiBenedetto RJ, Lyons HA. Massive hemoptysis. Arch Intern Med. 1968 Jun;121(6):495-8. No abstract available.
PubMed 5652400Garzon AA, Cerruti MM, Golding ME. Exsanguinating hemoptysis. J Thorac Cardiovasc Surg. 1982 Dec;84(6):829-33.
PubMed 7144217Jewkes J, Kay PH, Paneth M, Citron KM. Pulmonary aspergilloma: analysis of prognosis in relation to haemoptysis and survey of treatment. Thorax. 1983 Aug;38(8):572-8. doi: 10.1136/thx.38.8.572.
PubMed 6612647
Study at a glance
From the registry record, last updated by the sponsor on 22 Mar 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multicentric Randomized Trial Comparing the Bronchial Artery Embolization Combined With Medical Measures and the Medical Measures Alone in the Treatment of Non-severe Acute Hemoptysis of Mild-to-moderate Abundance
- ClinicalTrials.gov ID
- NCT01278199
- Acronym / sponsor ID
- ARTEMHYS / K081202
- Conditions
- Hemoptysis, Acute Disease
- Keywords
- Bronchial Artery Embolization, Non-severe Hemoptysis, Bleeding mild-to-moderate abundance, Volume ranging from 100 ml to 200 ml
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 73 participants (actual)
- Lead sponsor
- Assistance Publique - Hôpitaux de ParisUniversity, hospital or other
- Study start
- Nov 2011 (actual)
- Primary completion
- 27 Dec 2016 (actual)
- Study completion
- 27 Feb 2017 (actual)
- First posted
- 17 Jan 2011 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Severe hemoptysis is a life-threatening condition, with an unpredictable course. The efficacy of bronchial artery embolization (BAE) is well established for the treatment of severe hemoptysis, with short and long-term bleeding controls obtained in 70 to 100% and 50 to 90% of cases, respectively. As complications related to vascular interventional radiology may occur in 5 to 10% of cases, the benefit-risk balance might be less clear in acute hemoptysis of mild-to-moderate abundance (volume between 100 and 200 ml) and no criteria of severity (respiratory failure or hemodynamic instability). There is no available data comparing the safety and efficacy of BAE combined with medical measures to those of medical measures alone in the treatment of non-severe acute hemoptysis of mild-to-moderate abundance.
Detailed description
The study is a multicentric (n=8) randomized study, involving two parallel groups of patients with non-severe acute hemoptysis of mild-to-moderate abundance, related to a systemic bronchial or non-bronchial hypervascularization, and comparing the bronchial artery embolization combined with medical measures and the medical measures alone in this field.
The primary aim of the study is to evaluate the efficacy of BAE combined with medical measures in the treatment of non-severe acute hemoptysis of mild-to-moderate abundance, as compared with that of medical measures alone, by assessing the percentage of recurrence of hemoptysis at one month. Bleeding recurrence is defined as a volume of blood expectorated of at least 50 ml.
The second objectives of the study are to compare the efficacy of the two strategies at 3 months and to assess the safety of both strategies during hospitalization and follow-up.
Based on a previous study of our group (Reference 8), the number of patients in each group is 105, assuming a one-month bleeding recurrence rate of 11% in the group receiving BAE, as compared with 26% in the group assisted medically (a=.05; β=0.8).
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| 2 | Other | Other: Medicals measuresMedicals measures in the treatment of non-severe acute hemoptysis |
| 1 | Experimental | Other: bronchial artery embolizationbronchial artery embolization (BAE) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Non-severe acute hemoptysis (mild-to-moderate abundance and no criteria of severity).
- Age > 18 years
- Patients with social insurance
Key exclusion criteria (6 listed)
- Pregnant and/or lactating women
- Traumatic hemoptysis
- Severe hemoptysis (volume > 200 ml; respiratory failure; hemodynamic instability)
- Patients already enrolled in the study within the preceding 3 months
- Patients in palliative care, for whom there is no therapeutic plan at short-term
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Medicals measuresRest in bed. Monitoring of respiratory frequency. Fixation of intravenous route. Administration of nasal oxygenotherapy in order to maintain SpO2 > 90%. Administration of antituberculosis treatment, in case with active pulmonary tuberculosis known at admission or diagnosed during the stay. If necessary a bronchial wash out of will be realized by a bronchial fibroscopy with measures of use of cold serum, adrenalin xylocain or terlipressin. The administration of antibiotherapy by general mode according to the clinician appreciation. The administration of terlipressin according to the clinician appreciation. Against the cough treatment administration according to the clinician appreciation. | Other | 2 |
| bronchial artery embolizationThe bronchial artery embolization is practised within 48 hours which follow the hospital admission for non-severe acute hemoptysis. | Other | 1 |
Primary outcome
Bleeding recurrence rate, after initial therapeutic strategy.
Time frame: One month
Bleeding recurrence is defined as a volume of expectorated blood of 50 ml or more.
1 secondary outcome
Evaluation of the rate of serious adverse events
Time frame: 3 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Mar 2017.
- Background: PubMed 10208199Mal H, Rullon I, Mellot F, Brugiere O, Sleiman C, Menu Y, Fournier M. Immediate and long-term results of bronchial artery embolization for life-threatening hemoptysis. Chest. 1999 Apr;115(4):996-1001. doi: 10.1378/chest.115.4.996.
- Background: PubMed 13738524PURSEL SE, LINDSKOG GE. Hemoptysis. A clinical evaluation of 105 patients examined consecutively on a thoracic surgical service. Am Rev Respir Dis. 1961 Sep;84:329-36. doi: 10.1164/arrd.1961.84.3.329. No abstract available.
- Background: PubMed 9266882Hirshberg B, Biran I, Glazer M, Kramer MR. Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital. Chest. 1997 Aug;112(2):440-4. doi: 10.1378/chest.112.2.440.
- Background: PubMed 12388502Revel MP, Fournier LS, Hennebicque AS, Cuenod CA, Meyer G, Reynaud P, Frija G. Can CT replace bronchoscopy in the detection of the site and cause of bleeding in patients with large or massive hemoptysis? AJR Am J Roentgenol. 2002 Nov;179(5):1217-24. doi: 10.2214/ajr.179.5.1791217.
- Background: PubMed 16272972Mal H. [Role of surgery in the management of severe haemoptysis]. Rev Mal Respir. 2005 Nov;22(5 Pt 1):717-9. doi: 10.1016/s0761-8425(05)85627-x. No abstract available. French.
- Background: PubMed 13680121Picard C, Parrot A, Boussaud V, Lavole A, Saidi F, Mayaud C, Carette MF. Massive hemoptysis due to Rasmussen aneurysm: detection with helicoidal CT angiography and successful steel coil embolization. Intensive Care Med. 2003 Oct;29(10):1837-9. doi: 10.1007/s00134-003-1912-y. Epub 2003 Sep 13.
- Background: PubMed 6333165Remy J, Lemaitre L, Lafitte JJ, Vilain MO, Saint Michel J, Steenhouwer F. Massive hemoptysis of pulmonary arterial origin: diagnosis and treatment. AJR Am J Roentgenol. 1984 Nov;143(5):963-9. doi: 10.2214/ajr.143.5.963.
- Background: PubMed 17302979Fartoukh M, Khalil A, Louis L, Carette MF, Bazelly B, Cadranel J, Mayaud C, Parrot A. An integrated approach to diagnosis and management of severe haemoptysis in patients admitted to the intensive care unit: a case series from a referral centre. Respir Res. 2007 Feb 15;8(1):11. doi: 10.1186/1465-9921-8-11.
- Background: PubMed 17332480Savale L, Parrot A, Khalil A, Antoine M, Theodore J, Carette MF, Mayaud C, Fartoukh M. Cryptogenic hemoptysis: from a benign to a life-threatening pathologic vascular condition. Am J Respir Crit Care Med. 2007 Jun 1;175(11):1181-5. doi: 10.1164/rccm.200609-1362OC. Epub 2007 Mar 1.
- Background: PubMed 16418239Bruzzi JF, Remy-Jardin M, Delhaye D, Teisseire A, Khalil C, Remy J. Multi-detector row CT of hemoptysis. Radiographics. 2006 Jan-Feb;26(1):3-22. doi: 10.1148/rg.261045726.
- Background: PubMed 17989162Khalil A, Parrot A, Nedelcu C, Fartoukh M, Marsault C, Carette MF. Severe hemoptysis of pulmonary arterial origin: signs and role of multidetector row CT angiography. Chest. 2008 Jan;133(1):212-9. doi: 10.1378/chest.07-1159. Epub 2007 Nov 7.
- Background: PubMed 10205720Dweik RA, Stoller JK. Role of bronchoscopy in massive hemoptysis. Clin Chest Med. 1999 Mar;20(1):89-105. doi: 10.1016/s0272-5231(05)70129-5.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Muriel FARTOUKH, MD principal investigator
Tenon Hospital, AP-HP
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Medicals measures and bronchial artery embolization in people with Hemoptysis and Acute Disease, run by Assistance Publique - Hôpitaux de Paris 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 6 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: finished, as of the sponsor's last update on 22 Mar 2017. 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 is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Bleeding recurrence rate, after initial therapeutic strategy. (time frame: One month). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01278199, which also lists 41 linked publications.
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 22 Mar 2017.