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Chronic Obstructive Pulmonary DiseasePACENCT04140097

Predictors of Acute Exacerbation in Patients With COPD - an Observational Study

An observational study of Chronic Obstructive Pulmonary Disease and COPD, run by Schön Klinik Berchtesgadener Land at 1 site in Germany.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by respiratory problems and poor airflow with dyspnea and cough being the main symptoms. Acute exacerbations of COPD (AECOPD) are the most important events for patients with COPD that have a negative impact on patients´ quality of life… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Prospective monitoring of a large variety of parameters
How many people
355 participants
Where
1 siteGermany
Study dates
26 Feb 2020to 30 Apr 2026
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Patients with Chronic Obstructive Pulmonary Disease that are referred to an inpatient pulmonary rehabilitation program at the reference center.

Who may be able to join

  • confirmed diagnosis of Chronic Obstructive Pulmonary Disease according to Global Association for Obstructive Lung Disease stage II to IV
  • the ability to follow the rehabilitation protocol
  • provided written informed consent

Who cannot join

  • current primary diagnosis of asthma

Trial locations and contacts

1 site in 1 country.

Germany1 site
  • Schoen Klinik Berchtesgadener Land

    Schönau am Königssee, 83471

Other trials in Germany

About this study

Official title: Predictors of Acute Exacerbation in Patients With COPD - an Observational Study (PACE Trial)

Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by respiratory problems and poor airflow with dyspnea and cough being the main symptoms. Acute exacerbations of COPD (AECOPD) are the most important events for patients with COPD that have a negative impact on patients´ quality of life, accelerate disease progression, and can result in hospital admissions and death. It is of major clinical importance to determine predictors of an AECOPD and to identify patients who are at high risk for developing an acute exacerbation and/or to detect the beginning of or prevent an ongoing acute exacerbation as early as possible. Until now, research in the field of AECOPD has gathered and analyzed data only after manifestation of AECOPD until recovery and most of them used a retrospective study design. Therefore, the aim of this prospective trial is to collect clinical data in patients prior to the first visible clinical signs of an AECOPD to investigate potential early predictors of an AECOPD.

Read the detailed description

In total, 355 COPD patients will be included prospectively to this study during a 3-week inpatient pulmonary rehabilitation programme at the Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, (Germany). All patients will be closely monitored from admission to the study. Measures of lung function, blood samples, breath sampling, exercise tests, physical activity monitoring, cardiac parameters, quality of life and a symptom diary will be recorded regularly. Prior knowledge from this programme suggest that about 15% of patients will develop an AECOPD during this observational phase. If a patient develops an AECOPD there will be a comprehensive diagnostic assessment to differentiate between cardiac, pulmonary or cardio-pulmonary reasons for the AECOPD and to identify the type of exacerbation. The clinical diagnosis and management of an AECOPD will be determined by a pulmonologist according to criteria of international guidelines within the first 24h after the onset of clinical symptoms suggestive of an exacerbation. Collected clinical data from the days prior to AECOPD will be analyzed comprehensively to identify parameters with high prediction power for AECOPD. Furthermore, patients will perform follow-up measures at 6, 12 and 24 months following the initial observational phase (PR phase).

A wide range of predictor screening methods will be applied to identify significant predictors including cross tabulation tables, correlations, generalized linear models, mixed models, generalized estimation equation models and various predictor screening methods based on variable selection algorithms.

Study objectives Primary endpoint: To prospectively identify potential early, respiratory and/ or cardiac clinical predictors, laboratory parameters, breath print analyses and/ or changes in lung function and physical activity prior to an AECOPD in COPD patients.

Secondary endpoint(s):

  1. To identify potential mechanisms explaining the nature and composition of an acute exacerbation in COPD patients
  2. To identify and differentiate patterns of acute COPD exacerbation versus cardiac failure in COPD patients
  3. To investigate the potential role of an electronic-nose to capture exhaled breath metabolomic profiles for the early detection of an acute exacerbation in COPD patients ("COPD pre exacerbation breath print")
  4. To identify parameters influencing mortality and other adverse events in the total study cohort at 6, 12 and 24 months follow up
Being tested
Prospective monitoring of a large variety of parameters
Keywords
Predictor, Development, Pulmonary Rehabilitation
Medical subject headings
Pulmonary Disease, Chronic Obstructive

What participants receive

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

  • Prospective monitoring of a large variety of parametersOther

    Patients will be recruited during an inpatient pulmonary rehabilitation program. This setting offers a unique opportunity to study the phenomenon of an acute exacerbation of the Chronic Obstructive Pulmonary Disease prior to the first visible clinical sign and further on to have a follow up of the underlying mechanisms. All COPD patients that are referred to the reference center for a rehabilitation program will be included after providing written informed consent. Prospectively, a wide range of measurements will be collected. If a patient develops an acute exacerbation there will be a comprehensive diagnostic assessment to differentiate between pulmonary, cardiac or cardio-pulmonary reasons for the exacerbation. The clinical diagnosis of an AECOPD will be made by a pulmonologist according to criteria of international guidelines within the first 24h of clinical symptoms suggestive of an exacerbation.

Study groups in NCT04140097
Study groupRoleWhat they receive
COPD patients with acute exacerbationNot described
Receives: Other: Prospective monitoring of a large variety of parameters
COPD patients without acute exacerbationNot described
Receives: Other: Prospective monitoring of a large variety of parameters

What is being measured

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

  1. Change from baseline laboratory parameters at day 21

    following Parameters will be collected: c-reactive protein, cardiac Troponin I, hemoglobin A1c, Interleukin-1 beta, Interleukin-2, Interleukin-6, Interleukin 8, N-terminal probrain natriuretic peptide, Tumor necrosis factor alpha

    Measured: baseline and day 21

  2. Change from day 1 of an acute exacerbation in laboratory parameters at day 5

    following Parameters will be collected: c-reactive protein, cardiac Troponin I, hemoglobin A1c, Interleukin-1 beta, Interleukin-2, Interleukin-6, Interleukin 8, N-terminal probrain natriuretic peptide, Tumor necrosis factor alpha

    Measured: day 1 and 5 in case of an acute exacerbation

  3. Change from baseline lung function at day 21

    following Parameters will be collected: forced expiratory volume in 1 sec, forced vital capacity, total lung capacity, residual volume

    Measured: baseline and day 21

  4. Change from day 1 of an acute exacerbation in lung function at day 5

    following Parameters will be collected: forced expiratory volume in 1 sec, forced vital capacity, total lung capacity, residual volume

    Measured: day 1 and 5 in case of an acute exacerbation

  5. Change from baseline Cardiac Doppler echocardiography at day 21

    Left and right heart echocardiography will be performed

    Measured: baseline and day 21

  6. Change from day 1 of an acute exacerbation in Cardiac Doppler echocardiography at day 5

    Left and right heart echocardiography will be performed

    Measured: day 1 and 5 in case of an acute exacerbation

  7. Change from baseline breath volatile organic compounds Analysis to day 4, 8, 11, 15 and 18

    breath samples will be analyzed by ion-mobility spectrometry and gaschromatography/mass spectrometry

    Measured: day 1, 4, 8, 11, 15, 18

  8. Change in baseline exercise Performance at day 21

    following tests will be performed: 6-Minute walk test, sit-to-stand-test, Peak quadriceps and Hand grip force,

    Measured: day 1 and 21

  9. Change from baseline Quality of life assessed by Short Form - 36 Questionnaire at days 21, day 180, day360, day 720

    the scale of the physical and mental Health component summary score ranges from 0 to 100 Points with higher scores indicating better Quality of lif

    Measured: baseline, day 21, day 180, day 360, day 720

  10. Change from baseline functional status assessed by Modified Medical Research Counsil score at days 21, day 180, day360, day 720

    the score ranges from category 0 to 4 with higher scores indicating higher impairment in function status

    Measured: baseline, day 21, day 180, day 360, day 720

  11. Change from baseline anxiety status assessed by Chronic Obstructive Pulmonary Disease Anxiety Questionnaire at days 21, day 180, day360, day 720

    the total score ranges from 0 to 112 Points with higher scores indicating worse anxiety status

    Measured: baseline, day 21, day 180, day 360, day 720

  12. Change from baseline Depression status assessed by Patient Health Questionnaire 9 at days 21, day 180, day360, day 720

    the total score ranges from 0 to 27 Points with higher scores indicating worse Depression symptoms

    Measured: baseline, day 21, day 180, day 360, day 720

  13. Change from baseline disease specific Quality of life assessed by Chronic Obstructive Pulmonary Disease Assessment Test at days 21, day 180, day360, day 720

    total score ranges from 0 to 40 points with higher scores indicating worse quality of life

    Measured: baseline, (day 1 and 5 in case of an acute exacerbation), day 21, day 180, day 360, day 720

  14. Self-reported patient diary

    The EXAcerbations of Chronic pulmonary disease Tool will be used

    Measured: once daily from day 1 to day 21

  15. physical activity monitoring

    Using the Actigraph device following Parameters will be collected: steps per day and physical activity levels

    Measured: continuous monitoring from day 1 to day 21

  16. Change in Survival Status from baseline at 6, 12 and 24 months

    Survival Status will be assessed by phone calls

    Measured: baseline, at 6, 12 and 24 months

  17. cough events

    Number of nocturnal cough events recorded by NELA sound device (Carepath)

    Measured: Recording from day 1 to day 21 at night only

  18. Self-reported patient symptom diary

    The COPD Exacerbation Recognition Tool (CERT) is used. The CERT asks about symptoms of increased cough, sputum production, shortness of breath, labored breathing, and reduced physical activity. The total score ranges from 0 (symptoms as usual) to 5 (severe deterioration compared to usual).

    Measured: Once daily from day 1 to day 21

Timeline

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

  1. First posted25 Oct 2019
  2. Study start26 Feb 2020
  3. Primary completion30 Apr 2024
  4. Study completion30 Apr 2026 (estimated)

Resources

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
Cohort
Time perspective
Prospective
Enrolment
355 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04140097
Sponsor's protocol ID
PACE Trial
Acronym
PACE
Status last verified
Nov 2024
First submitted
26 Sep 2019
Last updated
8 Nov 2024
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Gloeckl R, Kenn K, Kroll D, Schneeberger T, Jarosch I, Wittenberg M, Hitzl W, Claussen J, Jones P, Vogelmeier CF, Koczulla R. Timely management of COPD exacerbations is associated with limited acute deterioration and early recovery: a prospective observational study. Respir Res. 2026 Jul 11;27(1):279. doi: 10.1186/s12931-026-03802-3.

    PubMed 42432679
  • Gloeckl R, Jones PW, Kroll D, Jarosch I, Schneeberger T, Claussen J, Schmidt P, Vogelmeier CF, Kenn K, Koczulla AR. Can Patient Education Lead the Way? Head-To-Head Comparison of EXACT and CERT for Early Recognition of Acute COPD Exacerbations. Respirology. 2026 Mar;31(3):256-264. doi: 10.1002/resp.70170. Epub 2025 Nov 30.

    PubMed 41320645
  • Kenn K, Gloeckl R, Leitl D, Schneeberger T, Jarosch I, Hitzl W, Alter P, Sczepanski B, Winterkamp S, Boensch M, Schade-Brittinger C, Skevaki C, Holz O, Jones PW, Vogelmeier CF, Koczulla AR. Protocol for an observational study to identify potential predictors of an acute exacerbation in patients with chronic obstructive pulmonary disease (the PACE Study). BMJ Open. 2021 Feb 8;11(2):e043014. doi: 10.1136/bmjopen-2020-043014.

    PubMed 33558356

Questions about this trial

What is this clinical trial studying?

An observational study of Chronic Obstructive Pulmonary Disease and COPD, run by Schön Klinik Berchtesgadener Land at 1 site in Germany.

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 1 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: under way, not looking for participants, as of the sponsor's last update on 8 Nov 2024. 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 Germany. 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?

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?

Change from baseline laboratory parameters at day 21 (time frame: baseline and day 21). The study lists 18 primary outcomes in all. 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 NCT04140097, 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 8 Nov 2024.

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