COPD, Emphysema, Asthma COPD OverlapNCT03263130
Site and Mechanism(s) of Expiratory Airflow Limitation in COPD, Emphysema and Asthma-COPD Overlap
An observational study of COPD, Emphysema, Asthma COPD Overlap and Emphysema, run by Gelb, Arthur F., M.D. at 2 sites in United States.
Trial summary
The purpose of this cross-sectional, observational study is to evaluate the site and mechanism(s) for expiratory airflow limitation in chronic, treated, current or former smokers (>15 pack years) with COPD, Emphysema, and Asthma-COPD Overlap with mild to severe expiratory airflow limitation. Read more about this study
- Who is it for?
- Ages 30 years and olderHealthy volunteers can take part
- Conditions the study is for
- COPD, Emphysema, Asthma COPD Overlap, Emphysema
- What is being tested?
- As above: diagnosis: COPD, Emphysema, Asthma-COPD Overlap
- How many people
- 60 participants
- Where
- 2 sitesUnited States
- Study dates
- 1 Jan 2017to 1 Dec 2027
- How long will I take part?
- 2 Months
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
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 30 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Study population: As above
Who may be able to join
- asthma- copd overlap
- emphysema in smokers with smoking history > 15 pack years
- COPD/ bronchitis and bronchiectasis in smokers with smoking history
- >15 pack years
Who cannot join
- non smokers
- any other pulmonary diagnosis
- pulmonary fibrosis
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
United States2 sites, 2 recruiting
- Recruiting
Arthur F Gelb MD
Lakewood, California, 90712
Arthur F Gelb, MD, 562-633-2204, afgelb@msn.com
Christine Fraser, 562-633-2204, familyfrase@msn.com
- Recruiting
Arthur F Gelb MD
Lakewood, California, 90712
Arthur F Gelb, MD, 562-633-2204, afgelb@msn.com
Christine Fraser, 562-633-2204, familyfrase@msn.com
About this study
The purpose of this cross-sectional, observational study is to evaluate the site and mechanism(s) for expiratory airflow limitation in chronic, treated, current or former smokers (>15 pack years) with COPD, Emphysema, and Asthma-COPD Overlap with mild to severe expiratory airflow limitation. Treatment may include short and long acting inhaled beta2agonists, short and long acting inhaled muscarinic receptor antagonists, inhaled and or oral corticosteroid, oral antibiotic, supplemental oxygen, and PDE type 4 inhibitor. In some cases, the patient may have had a history of asthma preceding the development of COPD (Asthma COPD Overlap).
Read the detailed description
The investigators are interested in determining the predominant site of expiratory airflow limitation including large central airways vs small peripheral airways/alveoli. In mild to moderate obstructive airways disease and emphysema, I believe routine spirometry including FEV 1(L), FVC (L), and FEV 1/FVC % may be normal, despite expiratory airflow limitation in lung peripheral airways. I also want to determine whether the mechanism(s) of expiratory airflow limitation are related to measured loss of lung elastic recoil or intrinsic obstruction of small peripheral airways or both. It is also important to determine the extent and distribution of emphysema using high resolution, thin section lung CT with voxel quantification. If available pathological analysis of lung surgical specimens and also formalin inflated lungs obtained at autopsy will also be studied. Blood studies will include but not limited to CBC, serum IgE, complete metabolic panel, and alpha 1 antitrypsin levels. Extensive lung function testing will also include spirometry tests before and after inhaled albuterol bronchodilation, lung volumes measured in a plethysmograph, diffusing capacity, measurement of lung elasticity that requires placement of an esophageal balloon, measurement of airflow after breathing a mixture of 80% helium-20%oxygen for 7-10 minutes, and measurements of exhaled nitric oxide. CAT scans of the lungs will be obtained to evaluate the presence, extent and distribution of emphysema and bronchiectasis. In some cases, bronchoscopy may be requested.
The above tests may be uncomfortable but should cause no harm.
- Conditions
- COPD, Emphysema, Asthma COPD Overlap, Emphysema
- Being tested
- As above: diagnosis: COPD, Emphysema, Asthma-COPD Overlap
- Keywords
- COPD, Emphysema, Asthma COPD Overlap
- Medical subject headings
- Pulmonary Disease, Chronic Obstructive, Emphysema
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
As above: diagnosis: COPD, Emphysema, Asthma-COPD OverlapOther
| Study group | Role | What they receive |
|---|---|---|
| COPD, Emphysema, Asthma-COPD Overlap | Based on clinical, pathologic, laboratory, physiologic and radiologic differences, patient groups can be described. Receives: Other: As above: diagnosis: COPD, Emphysema, Asthma-COPD Overlap |
What is being measured
The primary outcome is the main question the study is designed to answer.
Site and Mechanism(s) of Expiratory Airflow Limitation
Contribution of loss of lung lastic recoil vs intrinsic airway obstruction
Measured: 4 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Aug 2017
- Study start1 Jan 2017
- Primary completion1 Jan 2027 (estimated)
- Study completion1 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (18)Papers the sponsor has linked to this study.
- Other trials for COPD, Emphysema, Asthma COPD OverlapStudies of the same condition, open and under way.
- 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
- Observational
- Observational model
- Case only
- Time perspective
- Cross-sectional
- Enrolment
- 60 participants (estimated)
- Target duration
- 2 Months
Sponsor and investigators
- Lead sponsor
- Gelb, Arthur F., M.D.
- Responsible party
- Sponsor
- Investigators
- Arthur F Gelb, MD, Principal investigator, Clin Prof Geffen School of Medicine at UCLA Medical CenterArthur F Gelb, MD, Study director, Clin Prof Geffen School of Medicine at UCLA Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03263130
- Sponsor's protocol ID
- 1234567
- Status last verified
- Oct 2023
- First submitted
- 17 Aug 2017
- Last updated
- 27 Oct 2023
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Results of tests
Publications
Qaseem A, Wilt TJ, Weinberger SE, Hanania NA, Criner G, van der Molen T, Marciniuk DD, Denberg T, Schunemann H, Wedzicha W, MacDonald R, Shekelle P; American College of Physicians; American College of Chest Physicians; American Thoracic Society; European Respiratory Society. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Ann Intern Med. 2011 Aug 2;155(3):179-91. doi: 10.7326/0003-4819-155-3-201108020-00008.
PubMed 21810710Alcaide AB, Sanchez-Salcedo P, Bastarrika G, Campo A, Berto J, Ocon MD, Fernandez-Montero A, Celli BR, Zulueta JJ, de-Torres JP. Clinical Features of Smokers With Radiological Emphysema But Without Airway Limitation. Chest. 2017 Feb;151(2):358-365. doi: 10.1016/j.chest.2016.10.044. Epub 2016 Nov 3.
PubMed 27818328Mannino DM, Make BJ. Is it time to move beyond the "O" in early COPD? Eur Respir J. 2015 Dec;46(6):1535-7. doi: 10.1183/13993003.01436-2015. No abstract available.
PubMed 26621878Rennard SI, Drummond MB. Early chronic obstructive pulmonary disease: definition, assessment, and prevention. Lancet. 2015 May 2;385(9979):1778-1788. doi: 10.1016/S0140-6736(15)60647-X.
PubMed 25943942Harvey BG, Strulovici-Barel Y, Kaner RJ, Sanders A, Vincent TL, Mezey JG, Crystal RG. Risk of COPD with obstruction in active smokers with normal spirometry and reduced diffusion capacity. Eur Respir J. 2015 Dec;46(6):1589-1597. doi: 10.1183/13993003.02377-2014. Epub 2015 Nov 5.
PubMed 26541521Johns DP, Walters JA, Walters EH. Diagnosis and early detection of COPD using spirometry. J Thorac Dis. 2014 Nov;6(11):1557-69. doi: 10.3978/j.issn.2072-1439.2014.08.18.
PubMed 25478197Woodruff PG, Barr RG, Bleecker E, Christenson SA, Couper D, Curtis JL, Gouskova NA, Hansel NN, Hoffman EA, Kanner RE, Kleerup E, Lazarus SC, Martinez FJ, Paine R 3rd, Rennard S, Tashkin DP, Han MK; SPIROMICS Research Group. Clinical Significance of Symptoms in Smokers with Preserved Pulmonary Function. N Engl J Med. 2016 May 12;374(19):1811-21. doi: 10.1056/NEJMoa1505971.
PubMed 27168432Rodriguez-Roisin R, Han MK, Vestbo J, Wedzicha JA, Woodruff PG, Martinez FJ. Chronic Respiratory Symptoms with Normal Spirometry. A Reliable Clinical Entity? Am J Respir Crit Care Med. 2017 Jan 1;195(1):17-22. doi: 10.1164/rccm.201607-1376PP. No abstract available.
PubMed 27598473Martinez CH, Diaz AA, Meldrum C, Curtis JL, Cooper CB, Pirozzi C, Kanner RE, Paine R 3rd, Woodruff PG, Bleecker ER, Hansel NN, Barr RG, Marchetti N, Criner GJ, Kazerooni EA, Hoffman EA, Ross BD, Galban CJ, Cigolle CT, Martinez FJ, Han MK; SPIROMICS Investigators. Age and Small Airway Imaging Abnormalities in Subjects with and without Airflow Obstruction in SPIROMICS. Am J Respir Crit Care Med. 2017 Feb 15;195(4):464-472. doi: 10.1164/rccm.201604-0871OC.
PubMed 27564413Regan EA, Lynch DA, Curran-Everett D, Curtis JL, Austin JH, Grenier PA, Kauczor HU, Bailey WC, DeMeo DL, Casaburi RH, Friedman P, Van Beek EJ, Hokanson JE, Bowler RP, Beaty TH, Washko GR, Han MK, Kim V, Kim SS, Yagihashi K, Washington L, McEvoy CE, Tanner C, Mannino DM, Make BJ, Silverman EK, Crapo JD; Genetic Epidemiology of COPD (COPDGene) Investigators. Clinical and Radiologic Disease in Smokers With Normal Spirometry. JAMA Intern Med. 2015 Sep;175(9):1539-49. doi: 10.1001/jamainternmed.2015.2735.
PubMed 26098755Gelb AF, Hogg JC, Muller NL, Schein MJ, Kuei J, Tashkin DP, Epstein JD, Kollin J, Green RH, Zamel N, Elliott WM, Hadjiaghai L. Contribution of emphysema and small airways in COPD. Chest. 1996 Feb;109(2):353-9. doi: 10.1378/chest.109.2.353.
PubMed 8620705Gelb AF, Schein M, Kuei J, Tashkin DP, Muller NL, Hogg JC, Epstein JD, Zamel N. Limited contribution of emphysema in advanced chronic obstructive pulmonary disease. Am Rev Respir Dis. 1993 May;147(5):1157-61. doi: 10.1164/ajrccm/147.5.1157.
PubMed 8484625Gelb AF, Yamamoto A, Verbeken EK, Nadel JA. Unraveling the Pathophysiology of the Asthma-COPD Overlap Syndrome: Unsuspected Mild Centrilobular Emphysema Is Responsible for Loss of Lung Elastic Recoil in Never Smokers With Asthma With Persistent Expiratory Airflow Limitation. Chest. 2015 Aug;148(2):313-320. doi: 10.1378/chest.14-2483.
PubMed 25950858Gelb AF, Gold WM, Wright RR, Bruch HR, Nadel JA. Physiologic diagnosis of subclinical emphysema. Am Rev Respir Dis. 1973 Jan;107(1):50-63. doi: 10.1164/arrd.1973.107.1.50. No abstract available.
PubMed 4683321Gelb AF, Zamel N. Simplified diagnosis of small-airway obstruction. N Engl J Med. 1973 Feb 22;288(8):395-8. doi: 10.1056/NEJM197302222880805. No abstract available.
PubMed 4684043
Study at a glance
From the registry record, last updated by the sponsor on 27 Oct 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Site and Mechanism(s) of Expiratory Airflow Limitation in COPD, Emphysema and Asthma-COPD Overlap
- ClinicalTrials.gov ID
- NCT03263130
- Acronym / sponsor ID
- 1234567
- Conditions
- COPD, Emphysema, Asthma COPD Overlap, Emphysema
- Keywords
- COPD, Emphysema, Asthma COPD Overlap
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Gelb, Arthur F., M.D.
- Study start
- 1 Jan 2017 (actual)
- Primary completion
- 1 Jan 2027 (estimated)
- Study completion
- 1 Dec 2027 (estimated)
- First posted
- 28 Aug 2017 (actual)
- 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.
The purpose of this cross-sectional, observational study is to evaluate the site and mechanism(s) for expiratory airflow limitation in chronic, treated, current or former smokers (>15 pack years) with COPD, Emphysema, and Asthma-COPD Overlap with mild to severe expiratory airflow limitation. Treatment may include short and long acting inhaled beta2agonists, short and long acting inhaled muscarinic receptor antagonists, inhaled and or oral corticosteroid, oral antibiotic, supplemental oxygen, and PDE type 4 inhibitor. In some cases, the patient may have had a history of asthma preceding the development of COPD (Asthma COPD Overlap).
Detailed description
The investigators are interested in determining the predominant site of expiratory airflow limitation including large central airways vs small peripheral airways/alveoli. In mild to moderate obstructive airways disease and emphysema, I believe routine spirometry including FEV 1(L), FVC (L), and FEV 1/FVC % may be normal, despite expiratory airflow limitation in lung peripheral airways. I also want to determine whether the mechanism(s) of expiratory airflow limitation are related to measured loss of lung elastic recoil or intrinsic obstruction of small peripheral airways or both. It is also important to determine the extent and distribution of emphysema using high resolution, thin section lung CT with voxel quantification. If available pathological analysis of lung surgical specimens and also formalin inflated lungs obtained at autopsy will also be studied. Blood studies will include but not limited to CBC, serum IgE, complete metabolic panel, and alpha 1 antitrypsin levels. Extensive lung function testing will also include spirometry tests before and after inhaled albuterol bronchodilation, lung volumes measured in a plethysmograph, diffusing capacity, measurement of lung elasticity that requires placement of an esophageal balloon, measurement of airflow after breathing a mixture of 80% helium-20%oxygen for 7-10 minutes, and measurements of exhaled nitric oxide. CAT scans of the lungs will be obtained to evaluate the presence, extent and distribution of emphysema and bronchiectasis. In some cases, bronchoscopy may be requested.
The above tests may be uncomfortable but should cause no harm.
Study design
- Observational model
- Case only
- Time perspective
- Cross-sectional
- Target follow-up
- 2 Months
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| COPD, Emphysema, Asthma-COPD Overlap | – | Other: As above: diagnosis: COPD, Emphysema, Asthma-COPD OverlapBased on clinical, pathologic, laboratory, physiologic and radiologic differences, patient groups can be described. |
Who may qualify
- Ages
- 30 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
- Study population
- As above
Key inclusion criteria (4 listed)
- asthma- copd overlap
- emphysema in smokers with smoking history > 15 pack years
- COPD/ bronchitis and bronchiectasis in smokers with smoking history
- >15 pack years
Key exclusion criteria (3 listed)
- non smokers
- any other pulmonary diagnosis
- pulmonary fibrosis
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 |
|---|---|---|
| As above: diagnosis: COPD, Emphysema, Asthma-COPD Overlap | Other | COPD, Emphysema, Asthma-COPD Overlap |
Primary outcome
Site and Mechanism(s) of Expiratory Airflow Limitation
Time frame: 4 years
Contribution of loss of lung lastic recoil vs intrinsic airway obstruction
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Oct 2023.
- Results publication: PubMed 21810710Qaseem A, Wilt TJ, Weinberger SE, Hanania NA, Criner G, van der Molen T, Marciniuk DD, Denberg T, Schunemann H, Wedzicha W, MacDonald R, Shekelle P; American College of Physicians; American College of Chest Physicians; American Thoracic Society; European Respiratory Society. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Ann Intern Med. 2011 Aug 2;155(3):179-91. doi: 10.7326/0003-4819-155-3-201108020-00008.
- Results publication: PubMed 27818328Alcaide AB, Sanchez-Salcedo P, Bastarrika G, Campo A, Berto J, Ocon MD, Fernandez-Montero A, Celli BR, Zulueta JJ, de-Torres JP. Clinical Features of Smokers With Radiological Emphysema But Without Airway Limitation. Chest. 2017 Feb;151(2):358-365. doi: 10.1016/j.chest.2016.10.044. Epub 2016 Nov 3.
- Results publication: PubMed 26621878Mannino DM, Make BJ. Is it time to move beyond the "O" in early COPD? Eur Respir J. 2015 Dec;46(6):1535-7. doi: 10.1183/13993003.01436-2015. No abstract available.
- Results publication: PubMed 25943942Rennard SI, Drummond MB. Early chronic obstructive pulmonary disease: definition, assessment, and prevention. Lancet. 2015 May 2;385(9979):1778-1788. doi: 10.1016/S0140-6736(15)60647-X.
- Results publication: PubMed 26541521Harvey BG, Strulovici-Barel Y, Kaner RJ, Sanders A, Vincent TL, Mezey JG, Crystal RG. Risk of COPD with obstruction in active smokers with normal spirometry and reduced diffusion capacity. Eur Respir J. 2015 Dec;46(6):1589-1597. doi: 10.1183/13993003.02377-2014. Epub 2015 Nov 5.
- Results publication: PubMed 25478197Johns DP, Walters JA, Walters EH. Diagnosis and early detection of COPD using spirometry. J Thorac Dis. 2014 Nov;6(11):1557-69. doi: 10.3978/j.issn.2072-1439.2014.08.18.
- Results publication: PubMed 27168432Woodruff PG, Barr RG, Bleecker E, Christenson SA, Couper D, Curtis JL, Gouskova NA, Hansel NN, Hoffman EA, Kanner RE, Kleerup E, Lazarus SC, Martinez FJ, Paine R 3rd, Rennard S, Tashkin DP, Han MK; SPIROMICS Research Group. Clinical Significance of Symptoms in Smokers with Preserved Pulmonary Function. N Engl J Med. 2016 May 12;374(19):1811-21. doi: 10.1056/NEJMoa1505971.
- Results publication: PubMed 27598473Rodriguez-Roisin R, Han MK, Vestbo J, Wedzicha JA, Woodruff PG, Martinez FJ. Chronic Respiratory Symptoms with Normal Spirometry. A Reliable Clinical Entity? Am J Respir Crit Care Med. 2017 Jan 1;195(1):17-22. doi: 10.1164/rccm.201607-1376PP. No abstract available.
- Results publication: PubMed 27564413Martinez CH, Diaz AA, Meldrum C, Curtis JL, Cooper CB, Pirozzi C, Kanner RE, Paine R 3rd, Woodruff PG, Bleecker ER, Hansel NN, Barr RG, Marchetti N, Criner GJ, Kazerooni EA, Hoffman EA, Ross BD, Galban CJ, Cigolle CT, Martinez FJ, Han MK; SPIROMICS Investigators. Age and Small Airway Imaging Abnormalities in Subjects with and without Airflow Obstruction in SPIROMICS. Am J Respir Crit Care Med. 2017 Feb 15;195(4):464-472. doi: 10.1164/rccm.201604-0871OC.
- Results publication: PubMed 26098755Regan EA, Lynch DA, Curran-Everett D, Curtis JL, Austin JH, Grenier PA, Kauczor HU, Bailey WC, DeMeo DL, Casaburi RH, Friedman P, Van Beek EJ, Hokanson JE, Bowler RP, Beaty TH, Washko GR, Han MK, Kim V, Kim SS, Yagihashi K, Washington L, McEvoy CE, Tanner C, Mannino DM, Make BJ, Silverman EK, Crapo JD; Genetic Epidemiology of COPD (COPDGene) Investigators. Clinical and Radiologic Disease in Smokers With Normal Spirometry. JAMA Intern Med. 2015 Sep;175(9):1539-49. doi: 10.1001/jamainternmed.2015.2735.
- Results publication: PubMed 8620705Gelb AF, Hogg JC, Muller NL, Schein MJ, Kuei J, Tashkin DP, Epstein JD, Kollin J, Green RH, Zamel N, Elliott WM, Hadjiaghai L. Contribution of emphysema and small airways in COPD. Chest. 1996 Feb;109(2):353-9. doi: 10.1378/chest.109.2.353.
- Results publication: PubMed 8484625Gelb AF, Schein M, Kuei J, Tashkin DP, Muller NL, Hogg JC, Epstein JD, Zamel N. Limited contribution of emphysema in advanced chronic obstructive pulmonary disease. Am Rev Respir Dis. 1993 May;147(5):1157-61. doi: 10.1164/ajrccm/147.5.1157.
- Individual participant dataSharing planned: Yes. Results of tests
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.
Arthur F Gelb, MD principal investigator
Clin Prof Geffen School of Medicine at UCLA Medical Center
Arthur F Gelb, MD study director
Clin Prof Geffen School of Medicine at UCLA Medical Center
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of COPD, Emphysema, Asthma COPD Overlap and Emphysema, run by Gelb, Arthur F., M.D. at 2 sites in United States.
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 4 inclusion and 3 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: looking for participants now, as of the sponsor's last update on 27 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in United States. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Arthur F Gelb, MD (562-633-2204, afgelb@msn.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Site and Mechanism(s) of Expiratory Airflow Limitation (time frame: 4 years). 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 NCT03263130, which also lists 18 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 27 Oct 2023.