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Idiopathic Pulmonary FibrosisPALIFNCT03229343

Impact of a Systematic Palliative Care on Quality of Life, in Advanced Idiopathic Pulmonary Fibrosis.

A study testing Supportive care in people with Idiopathic Pulmonary Fibrosis, run by Assistance Publique - Hôpitaux de Paris at 11 sites in France.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Idiopathic pulmonary fibrosis (IPF) is a rare and severe disease with a survival median between 2 and 4 years which leads to a profound alteration of the quality of life. In thoracic oncology, the systematic and early intervention of a palliative care team result in an improvement of quality of life for patients. Read more about this study

Who is it for?
Ages 41 years and older
Conditions the study is for
Idiopathic Pulmonary Fibrosis
What is being tested?
Supportive care
Could I receive a placebo?
No, everyone receives an active treatment
How many people
120 participants
Where
11 sitesFrance
Study dates
4 Dec 2017to Feb 2021
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 41 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age> 40 years
  • Patient with confirmed diagnosis of IPF according to the American Thoracic Society (ATS) / European Respiratory Society (ERS) / Japanese Respiratory Society (JRS) / Latin American Thoracic Association (ALAT) criteria. The patient may be included regardless of the date of diagnosis.
  • Advanced IPF with Forced Vital Capacity (FVC) <50%" of predicted value and / or Diffusing capacity for carbon monoxide ((DLCO) <30% of predicted value or inability to achieve the Functional Respiratory Investigations (EFR) due to respiratory severity. EFR dated less than 3 months.
  • Absence of argument for acute or subacute exacerbation in the last 6 months.
  • Patient who can be followed in ambulatory consultation/ outpatient consultation.
  • Informed consent signed (signed by the patient or in the presence of a third party for patients who are poorly fluent in French).
  • Affiliation to the social security system.

Who cannot join

  • Patient unable to respond to quality of life questionnaires.
  • Inability (physical or mental) to give a written informed consent.
  • Acute exacerbation of fibrosis in the previous 6 months.
  • Patient eligible for a pulmonary transplant.
  • Participation in other therapeutic trial
  • Patient cannot be followed in ambulatory consultation.
  • Patient under trustee

Trial locations and contacts

11 sites in 1 country.

Boris Duchemann, Dr contact

01 48 95 50 32

boris.duchemann@aphp.fr

Nacira DARGHAL, PhD contact

01 48 95 74 73

nacira.darghal@aphp.fr

11 sites in 1 country

France11 sites, 11 recruiting
  • Centre Hospitalier Robert Ballanger

    Aulnay-sous-Bois, 93602

    Jérome VIRALLY, Pr

    Not yet recruiting
  • Hôpital Avicenne

    Bobigny, 93000

    Boris DUCHEMANN, PI

    Recruiting
  • Centre Hospitalier de Versailles Andre Mignot

    Le Chesnay, 78150

    Nathalie MICHENOT, Dr

    Not yet recruiting
  • Hôpital LOUIS PRADEL

    Lyon, 69677

    Vicent COTTIN, Pr

    Recruiting
  • Hôpital NORD

    Marseille, 13015

    Martine REYNAUD GAUBERT, Pr

    Not yet recruiting
  • Hôpital MARC JACQUET

    Melun

    Djamel BENNEGADI, Dr

    Recruiting
  • Hôpital GEORGES POMPIDOU (HEGP)

    Paris, 75015

    Dominique ISRAEL-BIET, Pr

    Not yet recruiting
  • Hôpital Tenon

    Paris, 75020

    Jean Marc NACCACHE, Pr

    Not yet recruiting
  • Hôpital Pontchaillou

    Rennes, 35033

    Stéphane JOUNEAU, Pr

    Recruiting
  • Hôpital DELAFONTAINE

    Saint-Denis, 93200

    Isabelle LERAT, Dr

    Not yet recruiting
  • Hôpital LARREY

    Toulouse, 31059

    Grégoire PREVOT, Dr

    Not yet recruiting

Other trials in France

About this study

Official title: Impact of a Systematic Palliative Care on Quality of Life, in Advanced Idiopathic Pulmonary Fibrosis (IPF). A Randomized Multi-center Trial.

Idiopathic pulmonary fibrosis (IPF) is a rare and severe disease with a survival median between 2 and 4 years which leads to a profound alteration of the quality of life.

In thoracic oncology, the systematic and early intervention of a palliative care team result in an improvement of quality of life for patients.

Read more

In the princeps study published in 2010, the early intervention of a dedicated palliative care team was compared to standard care in a randomized trial of 150 patients and shows a significant improvement : (i) of quality of life (main objective), (ii) of depression scores and even overall survival (11.6 months vs. 8.9 months, P = 0.02), (iii) a benefit in terms of understanding the diagnosis and therapeutic goals (3), (iv) diminution of adapted hospitalization in end of life (in emergency or not).

Considering some analogy points between IPF and advanced lung cancer (prognosis, respiratory symptom, psychological burden), it seemed reasonable to assume that the joint systematic intervention of chest physician and palliative care team may provide a significant benefit in terms of quality of life for patients with severe IPF.

Read the detailed description

Idiopathic pulmonary fibrosis (IPF) is a rare and severe disease with a survival median between 2 and 4 years which leads to a profound alteration of the quality of life. This alteration results from different consequences of the IPF: progressive shortness of breath, irritative cough refractory to treatments, exhaustion, limitation of activity, social isolation, and psychic consequences such as fear, anxiety and depression.

The only current curative treatment of the disease is pulmonary transplantation, but it's only feasible for a minority of patients. Anti-fibrotic drugs, such as pirfenidone and nintedanib, are likely to slow the progression of IPF but have no impact on patients' quality of life.

The symptomatic treatment aimed at relieving respiratory discomfort and the patient's quality of life is therefore fundamental, and the IPF meets in many ways the challenges of lung cancer.

In thoracic oncology, the systematic and early intervention of a palliative care team result in an improvement of quality of life for patients.

In the princeps study published in 2010, the early intervention of a dedicated palliative care team was compared to standard care in a randomized trial of 150 patients and shows a significant improvement : (i) of quality of life (main objective), (ii) of depression scores and even overall survival (11.6 months vs. 8.9 months, P = 0.02), (iii) a benefit in terms of understanding the diagnosis and therapeutic goals (3), (iv) diminution of adapted hospitalization in end of life (in emergency or not).

Considering some analogy points between IPF and advanced lung cancer (prognosis, respiratory symptom, psychological burden), it seemed reasonable to assume that the joint systematic intervention of chest physician and palliative care team may provide a significant benefit in terms of quality of life for patients with severe IPF.

Objective:

To investigate the benefit on quality of life, evaluated after 6 months, of a systematic, formalized and joint intervention of a palliative intervention staff and a chest physician team compared to standard care for patients with severe IPF.

Secondary endpoints

  1. To evaluate the benefit of the systematic, formalized and joint intervention of a palliative care team and a chest physician team on:
  • Mood and depression
  • Understanding of diagnosis and therapeutic objectives, frequency of drafting of advance directives regarding end-of-life
  • Respiratory symptoms (cough and dyspnea)
  • The course of care, the use of palliative care stays and the duration of hospital stays (number and duration of hospitalizations).
  • Overall survival and place of death.
  1. Carry out a medico-economic study evaluating the incremental cost-utility and cost-effectiveness ratio (overall survival criterion)
Being tested
Supportive care
Keywords
idiopathic pulmonary fibrosis, palliative care
Medical subject headings
Idiopathic Pulmonary Fibrosis

What participants receive

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

  • Supportive careOther

    supportive care, systematic and joint to pneumological consultation, monthly, starting at M0 and continuing up to M6.

Study groups in NCT03229343
Study groupRoleWhat they receive
ExperimentalExperimentalSupportive care, systematic and joint to pneumological consultation, monthly, starting at M0 and continuing up to M6.
Receives: Other: Supportive care
standardNo interventionpneumological consultation performed at M0, M3 and M6

What is being measured

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

  1. The benefit of a systematic, formalized and joint intervention of a palliative intervention staff and a chest physician team on quality of life, evaluated after 6 months by the Short Form (36) Health Survey.

    The Short Form (36) Health Survey is a 36-item, patient-reported survey of patient health. The Short Form (36) Health Survey consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability. The eight sections are: vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, mental health. This score has already been used for IPF

    Measured: at 6 months after inclusion

Secondary outcomes (6)
  1. The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Mood and depression

    evaluated by the Hospital Anxiety and Depression questionnaire.

    • Understanding of diagnosis and therapeutic objectives, frequency of drafting of advance directives
    • Respiratory symptoms (dyspnea)
    • The course of care, the use of palliative care stays and the duration of hospital stays (number and duration of hospitalizations).
    • Overall survival and place of death.

    Measured: at 3 and 6 months after inclusion

  2. The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Understanding of diagnosis and therapeutic objectives, frequency of drafting of advance directives.

    the benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Understanding of diagnosis and therapeutic objectives, frequency of drafting of advance directives will be evaluated by the illness understanding questionnaire.

    Measured: at 3 and 6 months after inclusion

  3. The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Respiratory symptoms (dyspnea)

    The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on Respiratory symptoms (dyspnea) will be evaluated by St George's respiratory questionnaire (SGRQ) and Transition Dyspnea Index (TDI)

    Measured: at 3 and 6 months after inclusion

  4. The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the course of care.

    the benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the course of care, the use of palliative care stays and the duration of hospital stays (number and duration of hospitalizations)

    Measured: at 3 and 6 months after inclusion

  5. The benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the Overall survival.

    the benefit of the systematic, formalized and joint intervention of a supportive care and a pneumologist team on the Overall survival measured between inclusion and date of death or last news.

    Measured: between inclusion and date of death or last news. (survival follow-up visit at month 12)

  6. Carry out a medico-economic study evaluating the incremental cost-utility and cost-effectiveness ratio (overall survival criterion)

    This outcome is evaluated by the medico-economic questionnaire : EuroQol five dimensions questionnaire (EQ-5D)

    Measured: at 3 and 6 months after inclusion

Timeline

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

  1. First posted25 Jul 2017
  2. Study start4 Dec 2017
  3. Primary completionFeb 2020 (estimated)
  4. Study completionFeb 2021 (estimated)

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
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
Experimental arm : supportive care, systematic and joint to pneumological consultation, monthly, starting at M0 and continuing up to M6. Non interventionnel arm: only pneumological consultation performed at M0, M3 and M6.
Masking
None (open label)
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03229343
Sponsor's protocol ID
P150965
Acronym
PALIF
Status last verified
Jul 2017
First submitted
4 Jul 2017
Last updated
26 Jan 2018
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Swigris JJ, Brown KK, Behr J, du Bois RM, King TE, Raghu G, Wamboldt FS. The SF-36 and SGRQ: validity and first look at minimum important differences in IPF. Respir Med. 2010 Feb;104(2):296-304. doi: 10.1016/j.rmed.2009.09.006. Epub 2009 Oct 7.

    PubMed 19815403
  • Swigris JJ, Kuschner WG, Jacobs SS, Wilson SR, Gould MK. Health-related quality of life in patients with idiopathic pulmonary fibrosis: a systematic review. Thorax. 2005 Jul;60(7):588-94. doi: 10.1136/thx.2004.035220.

    PubMed 15994268
  • Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010 Aug 19;363(8):733-42. doi: 10.1056/NEJMoa1000678.

    PubMed 20818875

Questions about this trial

What is this clinical trial studying?

A study testing Supportive care in people with Idiopathic Pulmonary Fibrosis, run by Assistance Publique - Hôpitaux de Paris at 11 sites 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 7 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: status not confirmed, as of the sponsor's last update on 26 Jan 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites 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?

Results are not available in the source record.

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

Contact Boris Duchemann, Dr (01 48 95 50 32, boris.duchemann@aphp.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The benefit of a systematic, formalized and joint intervention of a palliative intervention staff and a chest physician team on quality of life, evaluated after 6 months by the Short Form (36) Health Survey. (time frame: at 6 months after inclusion). 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 NCT03229343, which also lists 3 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 26 Jan 2018.

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