COPD ExacerbationPhase 3eo-DriveNCT04234360
Eosinophil-driven Corticotherapy for Patients Hospitalized for COPD Exacerbation
A Phase 3 study testing 5 days of systemic corticotherapy (prednisone) in people with COPD Exacerbation, run by University Hospital, Montpellier at 18 sites in France.
Trial summary
The primary objective of this study is to compare treatment failure rates between a group of eosinophilic (eosinophilia > 2% on day 1 of hospitalization) patients hospitalised for a COPD exacerbation treated via corticotherapy versus a similar group treated via placebo. Read more about this study
- Who is it for?
- Ages 40 to 85 years
- Conditions the study is for
- COPD Exacerbation
- What is being tested?
- 5 days of systemic corticotherapy (prednisone)
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 182 participants
- Where
- 18 sitesFrance
- Study dates
- 12 Oct 2021to 30 Jan 2025
- Phase
- Phase 3
- 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 40 to 85 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adult patients admitted to a participating hospital (ward, ICU or emergency services) for an acute COPD exacerbation
- For patients with known COPD: COPD defined according to GOLD 2018 criteria: (1) Post-bronchodilator FEV1/FVC < 70% of predicted values; (2) > 10 pack years smoking history
- For incident COPD cases with no spirometric history: symptoms and exposure according to GOLD 2018 report will be considered for the diagnosis, but if the spirometric diagnosis is not confirmed during follow-up, then the patient will be excluded
- Signed consent has been obtained, or the appropriate emergency procedure (under French law) allows enrolment
- Subjects must be covered by public health insurance
- Patient available for 3 months of follow-up. Subjects must be able to attend all scheduled visits and to comply with all trial procedures.
Who cannot join
- Subject unable to read or write; language barrier
- Subject who is in a dependency or employment with the sponsor or investigator
- Pregnancy or lactation
- Patients who are prisoners or under other forms of judicial protection
- Patients under any kind of guardianship
- The patient has already participated in the present protocol
Show all 21Show fewer
- The patient is participating in another interventional study or has done so in the past 3 months
- The patient is in an exclusion period determined by a previous study
- The patient has been taking long-term systemic corticosteroids for longer than 1 month prior to inclusion
- The patient has already received > 1 mg/kg of systemic corticotherapy in the past 48h
- Intubated-ventilated patient
- Administration of oral experimental drug is impossible
- Cancer within the last 12 months
- Current diagnosis of Asthma
- T2-inflammation targeting biologics (Benralizumab, reslizumab, mepolizumab, dupilumab) treatment
- Admitted for any other reason including, but not limited to, pulmonary embolism, pneumothorax, heart failure
- Known allergy to corticosteroids
- Consideration of a potential negative drug interaction with corticosteroids (at the investigator's discretion)
- White blood cell formula already performed and distributed to implicated teams
- Directives for limitation-of-care ("LATA" in French) already established
- SARS-Cov2 positive test carry out during the COPD exacerbation
Trial locations and contacts
18 sites in 1 country.
18 sites in 1 country
France18 sites
CHU Amiens
Amiens
CHU Brest - Hôpital Caval Blanche
Brest
Clinique du Parc
Castelnau-le-Lez
CH Libourne
Libourne
Hospice Civils de Lyon
Lyon
APHM - Hôpital Nord
Marseille
CHU Montpellier
Montpellier
CHU Nancy
Nancy
CHU Nîmes
Nîmes
APHP - Hopital Européen Georges Pompidou
Paris
APHP - Hôpital BICHAT
Paris
APHP - Hôpital Cochin
Paris
APHP - Hôpital Universitaire Pitié-Salpétrière
Paris
CHU Bordeaux - Hôpital Haut Lévêque
Pessac
CHU Reims
Reims
CHRU Strasbourg
Strasbourg
Hôpital Larrey CHU Toulouse
Toulouse
Hôpital Nord Franche-Comté
Trévenans
About this study
Official title: Eosinophil-driven Corticotherapy for Patients Hospitalized for COPD Exacerbation: a Double-blind, Randomized, Controlled Trial
The primary objective of this study is to compare treatment failure rates between a group of eosinophilic (eosinophilia > 2% on day 1 of hospitalization) patients hospitalised for a COPD exacerbation treated via corticotherapy versus a similar group treated via placebo.
Secondarily, treatment failure rates will also be compared between a group of non-eosinophilic patients hospitalised for a COPD exacerbation treated via corticotherapy versus a similar group treated via placebo. Study arms will also be compared for additional aspects of efficacy and safety:
Read more
- speed of recovery during the initial hospitalization;
- corticosteroid side effects / induced comorbidities;
- changes in symptoms and episodes of exacerbation;
- pulmonary function, oxygen use and ventilation;
- patient trajectories and resource use (e.g. survival, consults, episodes of hospitalization, medications);
- drug consumption (especially as relates to COPD management, exacerbations and induced comorbidities);
- health status, quality of life, activity/disability;
- patient safety / adverse events in general.
Eosinophilia thresholds optimizing the prediction of corticosteroid response and COPD outcomes will be re-evaluated. The relationships between corticosteroid response and key biomarkers (e.g. infectious groups) will be thoroughly explored, including within eosinophil strata. Potential gender subgroups differences will also be evaluated.
Finally, in prevision of further exploratory studies, a biological collection and an imaging library will be created in association with this protocol. The biological collection will be used to explore the genetic basis and physiology linked with treatment response, gender and patient trajectories. The image library will be used as a platform for the exploration of new imaging markers developed, for example, via machine learning and affiliated techniques.
- Conditions
- COPD Exacerbation
- Being tested
- 5 days of systemic corticotherapy (prednisone), 5 days of placebo
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
5 days of systemic corticotherapy (prednisone)Drug
Patients randomized to this arm will receive 40 mg prednisone per os per day for 5 days. Other aspects of standard, recommended care (e.g. antibiotherapy) are respected.
5 days of placeboDrug
Patients randomized to this arm will receive an appropriate placebo per os for 5 days. Other aspects of standard, recommended care (e.g. antibiotherapy) are respected.
| Study group | Role | What they receive |
|---|---|---|
| Eosinophil count > 2%; corticotherapy | Experimental | Eosinophilic patients randomized to this arm will receive 5 days of corticotherapy. Receives: Drug: 5 days of systemic corticotherapy (prednisone) |
| Eosinophil count <= 2%; corticotherapy | Experimental | Non-eosinophilic patients randomized to this arm will receive 5 days of corticotherapy. Receives: Drug: 5 days of systemic corticotherapy (prednisone) |
| Eosinophil count > 2%; placebo | Placebo comparator | Eosinophilic patients randomized to this arm will receive 5 days of placebo. Receives: Drug: 5 days of placebo |
| Eosinophil count <= 2%; placebo | Placebo comparator | Non-eosinophilic patients randomized to this arm will receive 5 days of placebo. Receives: Drug: 5 days of placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Treatment failure
Treatment failure for the primary outcome is defined according to Niewoehner et al. (1999) as death from any cause or need for intubation and mechanical ventilation, readmission due to COPD, or intensification of pharmacologic therapy (defined as the prescription of open-label systemic glucocorticoids, high-dose inhaled glucocorticoids (more than eight puffs per day of triamcinolone acetonide or its equivalent), theophylline, or any combination of these three therapies) at three months. In addition, an investigator meeting determined additional components of treatment failure that should be added to Niewoehner's definition in order to bring it up-to-date :
- Initiation of non-invasive ventilation for >24h after first treatment administration
- Transfer to intensive care or indication for a transfer to intensive care. Incident limitations-of-care that can affect treatment failure should also be carefully noted.
Measured: 3 months
Secondary outcomes (76)
The speed of initial recovery: Time elapsed before showing signs of improvement
Measured: During initial hospitalization (expected maximum of 28 days)
The speed of initial recovery: Time elapsed in acidosis/hypercapnia
Measured: During initial hospitalization (expected maximum of 28 days)
The speed of initial recovery: Time elapsed before meeting pre-defined discharge criteria
Time elapsed before meeting pre-defined discharge criteria (acidosis has normalized, symptoms have returned to manageable levels, the patient is capable of performing minimal daily activities).
Measured: During initial hospitalization (expected maximum of 28 days)
Presence /absence of comorbidities or steroid side effects: glycemia
Measured: During initial hospitalization (expected maximum of 28 days)
Presence /absence of comorbidities or steroid side effects: glycemia
Measured: 1 month
Presence /absence of comorbidities or steroid side effects: glycemia
Measured: 3 months
The occurrence of new or worsened diabetes/hyperglycemia
Measured: Throughout the study (3 months)
Body mass index
Measured: Baseline (day 0)
Body mass index
Measured: At hospital discharge (expected maximum of 28 days)
Body mass index
Measured: 1 month
Body mass index
Measured: 3 month
Hospital anxiety and depression scale (HAD)
The HAD results in a score ranging from 0 (low anxiety or depression) to 21 (strong anxiety or depression).
Measured: baseline (day 0)
Hospital anxiety and depression scale (HAD)
The HAD results in a score ranging from 0 (low anxiety or depression) to 21 (strong anxiety or depression).
Measured: 3 months
The occurrence of any other potentially corticosteroid-induced comorbidities throughout the study
Measured: Throughout the study; 3 months
Episodes of pneumonia
Beginning and end dates of episodes.
Measured: Throughout the study; 3 months
Episodes of infection
Beginning and end dates of episodes.
Measured: Throughout the study; 3 months
Episodes of mild exacerbation.
Episodes of exacerbation will be recorded (date of start/finish for each episode) throughout the study.
Exacerbation severity is determined (GOLD 2018) as follows:
- mild: treated with short acting bronchodilators (SABDs) only,
- moderate: treated with SABDs plus antibiotics and/or oral corticosteroids,
- severe: patient required hospitalization or visits the emergency room.
Measured: Throughout the study; 3 months
Episodes of moderate exacerbation.
Episodes of exacerbation will be recorded (date of start/finish for each episode) throughout the study.
Exacerbation severity is determined (GOLD 2018) as follows:
- mild: treated with short acting bronchodilators (SABDs) only,
- moderate: treated with SABDs plus antibiotics and/or oral corticosteroids,
- severe: patient required hospitalization or visits the emergency room.
Measured: Throughout the study; 3 months
Episodes of severe exacerbation.
Episodes of exacerbation will be recorded (date of start/finish for each episode) throughout the study.
Exacerbation severity is determined (GOLD 2018) as follows:
- mild: treated with short acting bronchodilators (SABDs) only,
- moderate: treated with SABDs plus antibiotics and/or oral corticosteroids,
- severe: patient required hospitalization or visits the emergency room.
Measured: Throughout the study; 3 months
Forced expiratory volume in 1 second (litres)
Measured: At hospital discharge (expected maximum of 28 days)
Forced expiratory volume in 1 second (litres)
Measured: 3 months
Forced expiratory volume in 1 second (% predicted)
Measured: At hospital discharge (expected maximum of 28 days)
Forced expiratory volume in 1 second (% predicted)
Measured: 3 months
Forced vital capacity (litres)
Measured: At hospital discharge (expected maximum of 28 days)
Forced vital capacity (litres)
Measured: 3 months
Forced vital capacity (% predicted)
Measured: At hospital discharge (expected maximum of 28 days)
Forced vital capacity (% predicted)
Measured: 3 months
Residual volume (litres)
Measured: At hospital discharge (expected maximum of 28 days)
Residual volume (litres)
Measured: 3 months
Residual volume (% predicted)
Measured: At hospital discharge (expected maximum of 28 days)
Residual volume (% predicted)
Measured: 3 months
Total lung capacity (litres)
Measured: At hospital discharge (expected maximum of 28 days)
Total lung capacity (litres)
Measured: 3 months
Total lung capacity (% predicted)
Measured: At hospital discharge (expected maximum of 28 days)
Total lung capacity (% predicted)
Measured: 3 months
Oxygen needs (litres/min) during initial hospitalisation
Measured: At hospital discharge (expected maximum of 28 days)
Mode of pre-hospitalization living arrangements
At home, rehabilitation centre, assisted living centre, or other
Measured: Baseline (day 0)
Hospital discharge modality
At home, rehabilitation centre, assisted living centre, or other
Measured: At hospital discharge (expected maximum of 28 days)
Episodes of hospitalization
Episodes of hospitalization, distinguishing emergency department, intensive care, intermediate care and ward stays, will be recorded throughout the study .
Measured: Throughout the study; 3 months
Episodes of emergency department use
Measured: Throughout the study; 3 months
Episodes of intensive care
Measured: Throughout the study; 3 months
Consults
The number of consults and rehabilitation/therapy sessions in relation to COPD/respiratory symptoms (or not) will be tracked.
Measured: Throughout the study; 3 months
The cumulative days alive and event-free
The cumulative days alive and event-free (free from hospitalization, exacerbation, ventilation, oxygen use, pneumonia or infection)
Measured: Throughout the study; 3 months
Mortality/survival
Measured: Throughout the study; 3 months
Medications
Drug consumption episodes (including vaccines) will be recorded throughout the study and linked to COPD exacerbations, COPD maintenance therapy or corticosteroid-induced side effects as appropriate.
Measured: Throughout the study; 3 months
VAS scale for coughing
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: Every morning during hospitalization (expected maximum of 28 days)
VAS scale for coughing
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: 1 month
VAS scale for coughing
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: 3 months
VAS scale for dyspnoea
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: Every morning during hospitalization (expected maximum of 28 days)
VAS scale for dyspnoea
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: 1 month
VAS scale for dyspnoea
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: 3 months
VAS scale for sputum production
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: Every morning during hospitalization (expected maximum of 28 days)
VAS scale for sputum production
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: 1 month
VAS scale for sputum production
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: 3 months
VAS scale for sleep perturbation
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: Every morning during hospitalization (expected maximum of 28 days)
VAS scale for sleep perturbation
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: 1 month
VAS scale for sleep perturbation
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: 3 months
VAS scale for anxiety
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: Every morning during hospitalization (expected maximum of 28 days)
VAS scale for anxiety
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: 1 month
VAS scale for anxiety
Patient reported, separate visual analogue scales (VAS) for coughing, dyspnoea (at rest), sputum production, sleep perturbation and anxiety.
VAS scales range from 0 (absence of symptoms) to 10 (strongest possible symptoms imaginable).
Measured: 3 months
The Breathlessness, Cough and Sputum Scale
Symptoms are evaluated on a 5-point Likert-type scale ranging from 0 to 4, with higher scores indicating more severe symptoms.
Measured: Baseline (day 0)
The Breathlessness, Cough and Sputum Scale
Symptoms are evaluated on a 5-point Likert-type scale ranging from 0 to 4, with higher scores indicating more severe symptoms.
Measured: On hospital discharge (expected maximum of 28 days)
The Breathlessness, Cough and Sputum Scale
Symptoms are evaluated on a 5-point Likert-type scale ranging from 0 to 4, with higher scores indicating more severe symptoms.
Measured: 1 month
The Breathlessness, Cough and Sputum Scale
Symptoms are evaluated on a 5-point Likert-type scale ranging from 0 to 4, with higher scores indicating more severe symptoms.
Measured: 3 months
The modified medical research council (mMRC) dyspnoea scale
Scores range from 0 (none) to 4 (very severe).
Measured: Baseline (day 0)
The modified medical research council (mMRC) dyspnoea scale
Scores range from 0 (none) to 4 (very severe).
Measured: 3 months
The COPD assessment test
Scores range from 0-40 with higher scores indicative of greater COPD impact on health status.
Measured: Baseline (day 0)
The COPD assessment test
Scores range from 0-40 with higher scores indicative of greater COPD impact on health status.
Measured: 1 month
The COPD assessment test
Scores range from 0-40 with higher scores indicative of greater COPD impact on health status.
Measured: 3 months
The Euroqol (EQ-5D-5L) questionnaire
The descriptive system has five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), each described by five levels of intensity ("no problems", "slight problems", "moderate problems", "severe problems" and "extreme problems or complete inability"). This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.
Measured: Baseline (day 0)
The Euroqol (EQ-5D-5L) questionnaire
The descriptive system has five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), each described by five levels of intensity ("no problems", "slight problems", "moderate problems", "severe problems" and "extreme problems or complete inability"). This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.
Measured: 1 month
The Euroqol (EQ-5D-5L) questionnaire
The descriptive system has five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), each described by five levels of intensity ("no problems", "slight problems", "moderate problems", "severe problems" and "extreme problems or complete inability"). This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.
Measured: 3 months
The St George Respiratory Questionnaire
Scores range from 0 to 100, with higher scores indicating more limitations.
Measured: 3 months
Six minute walking tests
Measured: 1 month (optional)
Six minute walking tests
Measured: 3 months
The DIRECT questionnaire
DIRECT: Disability related to Chronic Obstructive Pulmonary Disease (COPD) tool The DIRECT questionnaire provides a score ranging between 0 and 34, with higher values indicating higher levels of disability.
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 posted21 Jan 2020
- Study start12 Oct 2021
- Primary completion30 Jan 2025
- Study completion30 Jan 2025
Why it stopped: low enrollment at participating centers
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for COPD ExacerbationStudies of the same condition, open and under way.
- More trials run by University Hospital, MontpellierThe 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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This is a randomised (1:1), 2-parallel arm, double-blind trial comparing outcomes for a group of eosinophilic COPD patients (n=150) treated via corticotherapy versus a 2nd, similar group (n=150) treated via placebo. Secondarily, the same comparison (2x n=150) will be made for non-eosinophilic patients (totally excluding non-eosinophilic patients would potentially affect biomarker knowledge and subsequent care decisions, leading to bias).
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 182 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Hospital, Montpellier
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Arnaud BOURDIN, Principal investigator, a-bourdin@chu-montpellier.fr
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04234360
- Sponsor's protocol ID
- RECHMPL19_0069 UF 7771
- Other IDs
- 2019-002724-33, LIC-18-18-0374, 2019
- Acronym
- eo-Drive
- Status last verified
- Jun 2026
- First submitted
- 13 Jan 2020
- Last updated
- 12 Jun 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: The general goal is to make the study data available to interested researchers as well as to provide proof of transparency for the study. Data (and an accompanying data dictionary) will be de-identified and potentially further cleaned or aggregated as the investigators deem necessary to protect participant anonymity. Data will be made available to persons who address a reasonable dataset request to the sponsor coordinating team (c/o Dr Carey Suehs, Department of Medical Information, Hôpital La Colombière, 39 avenue Charles Flahault, 34295 Montpellier Cedex 5, France). In accordance with French law, dataset usage requests must by approved by the French CNIL (Commission Nationale de l'Informatique et des Libertés : https://www.cnil.fr/professionnel) prior to access.
Publications
Suehs CM, Zysman M, Chenivesse C, Burgel PR, Couturaud F, Deslee G, Berger P, Raherison C, Devouassoux G, Brousse C, Roche N, Molimard M, Chinet T, Devillier P, Chanez P, Kessler R, Didier A, Martinat Y, Le Rouzic O, Bourdin A. Prioritising outcomes for evaluating eosinophil-guided corticosteroid therapy among patients with acute COPD exacerbations requiring hospitalisation: a Delphi consensus study. BMJ Open. 2020 Jul 1;10(7):e035811. doi: 10.1136/bmjopen-2019-035811.
PubMed 32611741
Study at a glance
From the registry record, last updated by the sponsor on 12 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Eosinophil-driven Corticotherapy for Patients Hospitalized for COPD Exacerbation: a Double-blind, Randomized, Controlled Trial
- ClinicalTrials.gov ID
- NCT04234360
- Acronym / sponsor ID
- eo-Drive / RECHMPL19_0069 UF 7771
- Conditions
- COPD Exacerbation
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: low enrollment at participating centers
- Enrolment
- 182 participants (actual)
- Lead sponsor
- University Hospital, MontpellierUniversity, hospital or other
- Study start
- 12 Oct 2021 (actual)
- Primary completion
- 30 Jan 2025 (actual)
- Study completion
- 30 Jan 2025 (actual)
- First posted
- 21 Jan 2020 (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 primary objective of this study is to compare treatment failure rates between a group of eosinophilic (eosinophilia > 2% on day 1 of hospitalization) patients hospitalised for a COPD exacerbation treated via corticotherapy versus a similar group treated via placebo.
Secondarily, treatment failure rates will also be compared between a group of non-eosinophilic patients hospitalised for a COPD exacerbation treated via corticotherapy versus a similar group treated via placebo. Study arms will also be compared for additional aspects of efficacy and safety:
- speed of recovery during the initial hospitalization;
- corticosteroid side effects / induced comorbidities;
- changes in symptoms and episodes of exacerbation;
- pulmonary function, oxygen use and ventilation;
- patient trajectories and resource use (e.g. survival, consults, episodes of hospitalization, medications);
- drug consumption (especially as relates to COPD management, exacerbations and induced comorbidities);
- health status, quality of life, activity/disability;
- patient safety / adverse events in general.
Eosinophilia thresholds optimizing the prediction of corticosteroid response and COPD outcomes will be re-evaluated. The relationships between corticosteroid response and key biomarkers (e.g. infectious groups) will be thoroughly explored, including within eosinophil strata. Potential gender subgroups differences will also be evaluated.
Finally, in prevision of further exploratory studies, a biological collection and an imaging library will be created in association with this protocol. The biological collection will be used to explore the genetic basis and physiology linked with treatment response, gender and patient trajectories. The image library will be used as a platform for the exploration of new imaging markers developed, for example, via machine learning and affiliated techniques.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 4
- Model description
- This is a randomised (1:1), 2-parallel arm, double-blind trial comparing outcomes for a group of eosinophilic COPD patients (n=150) treated via corticotherapy versus a 2nd, similar group (n=150) treated via placebo. Secondarily, the same comparison (2x n=150) will be made for non-eosinophilic patients (totally excluding non-eosinophilic patients would potentially affect biomarker knowledge and subsequent care decisions, leading to bias).
| Arm | Type | Receives |
|---|---|---|
| Eosinophil count > 2%; corticotherapy | Experimental | Drug: 5 days of systemic corticotherapy (prednisone)Eosinophilic patients randomized to this arm will receive 5 days of corticotherapy. |
| Eosinophil count <= 2%; corticotherapy | Experimental | Drug: 5 days of systemic corticotherapy (prednisone)Non-eosinophilic patients randomized to this arm will receive 5 days of corticotherapy. |
| Eosinophil count > 2%; placebo | Placebo comparator | Drug: 5 days of placeboEosinophilic patients randomized to this arm will receive 5 days of placebo. |
| Eosinophil count <= 2%; placebo | Placebo comparator | Drug: 5 days of placeboNon-eosinophilic patients randomized to this arm will receive 5 days of placebo. |
Who may qualify
- Ages
- 40 to 85 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Adult patients admitted to a participating hospital (ward, ICU or emergency services) for an acute COPD exacerbation
- For patients with known COPD: COPD defined according to GOLD 2018 criteria: (1) Post-bronchodilator FEV1/FVC < 70% of predicted values; (2) > 10 pack years smoking history
- For incident COPD cases with no spirometric history: symptoms and exposure according to GOLD 2018 report will be considered for the diagnosis, but if the spirometric diagnosis is not confirmed during follow-up, then the patient will be excluded
- Signed consent has been obtained, or the appropriate emergency procedure (under French law) allows enrolment
- Subjects must be covered by public health insurance
Key exclusion criteria (21 listed)
- Subject unable to read or write; language barrier
- Subject who is in a dependency or employment with the sponsor or investigator
- Pregnancy or lactation
- Patients who are prisoners or under other forms of judicial protection
- Patients under any kind of guardianship
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 |
|---|---|---|
| 5 days of systemic corticotherapy (prednisone)Patients randomized to this arm will receive 40 mg prednisone per os per day for 5 days. Other aspects of standard, recommended care (e.g. antibiotherapy) are respected. | Drug | Eosinophil count <= 2%; corticotherapy, Eosinophil count > 2%; corticotherapy |
| 5 days of placeboPatients randomized to this arm will receive an appropriate placebo per os for 5 days. Other aspects of standard, recommended care (e.g. antibiotherapy) are respected. | Drug | Eosinophil count <= 2%; placebo, Eosinophil count > 2%; placebo |
Primary outcome
Treatment failure
Time frame: 3 months
Treatment failure for the primary outcome is defined according to Niewoehner et al. (1999) as death from any cause or need for intubation and mechanical ventilation, readmission due to COPD, or intensification of pharmacologic therapy (defined as the prescription of open-label systemic glucocorticoids, high-dose inhaled glucocorticoids (more than eight puffs per day of triamcinolone acetonide or its equivalent), theophylline, or any combination of these three therapies) at three months. In addition, an investigator meeting determined additional components of treatment failure that should be added to Niewoehner's definition in order to bring it up-to-date : * Initiation of non-invasive ventilation for >24h after first treatment administration * Transfer to intensive care or indication for a transfer to intensive care. Incident limitations-of-care that can affect treatment failure should also be carefully noted.
76 secondary outcomes
The speed of initial recovery: Time elapsed before showing signs of improvement
Time frame: During initial hospitalization (expected maximum of 28 days)
The speed of initial recovery: Time elapsed in acidosis/hypercapnia
Time frame: During initial hospitalization (expected maximum of 28 days)
The speed of initial recovery: Time elapsed before meeting pre-defined discharge criteria
Time frame: During initial hospitalization (expected maximum of 28 days)
Presence /absence of comorbidities or steroid side effects: glycemia
Time frame: During initial hospitalization (expected maximum of 28 days)
Presence /absence of comorbidities or steroid side effects: glycemia
Time frame: 1 month
Presence /absence of comorbidities or steroid side effects: glycemia
Time frame: 3 months
The occurrence of new or worsened diabetes/hyperglycemia
Time frame: Throughout the study (3 months)
Body mass index
Time frame: Baseline (day 0)
Body mass index
Time frame: At hospital discharge (expected maximum of 28 days)
Body mass index
Time frame: 1 month
Body mass index
Time frame: 3 month
Hospital anxiety and depression scale (HAD)
Time frame: baseline (day 0)
Hospital anxiety and depression scale (HAD)
Time frame: 3 months
The occurrence of any other potentially corticosteroid-induced comorbidities throughout the study
Time frame: Throughout the study; 3 months
Episodes of pneumonia
Time frame: Throughout the study; 3 months
Episodes of infection
Time frame: Throughout the study; 3 months
Episodes of mild exacerbation.
Time frame: Throughout the study; 3 months
Episodes of moderate exacerbation.
Time frame: Throughout the study; 3 months
Episodes of severe exacerbation.
Time frame: Throughout the study; 3 months
Forced expiratory volume in 1 second (litres)
Time frame: At hospital discharge (expected maximum of 28 days)
Forced expiratory volume in 1 second (litres)
Time frame: 3 months
Forced expiratory volume in 1 second (% predicted)
Time frame: At hospital discharge (expected maximum of 28 days)
Forced expiratory volume in 1 second (% predicted)
Time frame: 3 months
Forced vital capacity (litres)
Time frame: At hospital discharge (expected maximum of 28 days)
Forced vital capacity (litres)
Time frame: 3 months
Forced vital capacity (% predicted)
Time frame: At hospital discharge (expected maximum of 28 days)
Forced vital capacity (% predicted)
Time frame: 3 months
Residual volume (litres)
Time frame: At hospital discharge (expected maximum of 28 days)
Residual volume (litres)
Time frame: 3 months
Residual volume (% predicted)
Time frame: At hospital discharge (expected maximum of 28 days)
Residual volume (% predicted)
Time frame: 3 months
Total lung capacity (litres)
Time frame: At hospital discharge (expected maximum of 28 days)
Total lung capacity (litres)
Time frame: 3 months
Total lung capacity (% predicted)
Time frame: At hospital discharge (expected maximum of 28 days)
Total lung capacity (% predicted)
Time frame: 3 months
Oxygen needs (litres/min) during initial hospitalisation
Time frame: At hospital discharge (expected maximum of 28 days)
Mode of pre-hospitalization living arrangements
Time frame: Baseline (day 0)
Hospital discharge modality
Time frame: At hospital discharge (expected maximum of 28 days)
Episodes of hospitalization
Time frame: Throughout the study; 3 months
Episodes of emergency department use
Time frame: Throughout the study; 3 months
Results and safety
The study was stopped early (reason given: low enrollment at participating centers). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Jun 2026.
- Results publication: PubMed 32611741Suehs CM, Zysman M, Chenivesse C, Burgel PR, Couturaud F, Deslee G, Berger P, Raherison C, Devouassoux G, Brousse C, Roche N, Molimard M, Chinet T, Devillier P, Chanez P, Kessler R, Didier A, Martinat Y, Le Rouzic O, Bourdin A. Prioritising outcomes for evaluating eosinophil-guided corticosteroid therapy among patients with acute COPD exacerbations requiring hospitalisation: a Delphi consensus study. BMJ Open. 2020 Jul 1;10(7):e035811. doi: 10.1136/bmjopen-2019-035811.
- eo-Drive on the Open Science FrameworkLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. The general goal is to make the study data available to interested researchers as well as to provide proof of transparency for the study. Data (and an accompanying data dictionary) will be de-identified and potentially further cleaned or aggregated as the investigators deem necessary to protect participant anonymity. Data will be made available to persons who address a reasonable dataset request to the sponsor coordinating team (c/o Dr Carey Suehs, Department of Medical Information, Hôpital La Colombière, 39 avenue Charles Flahault, 34295 Montpellier Cedex 5, France). In accordance with French law, dataset usage requests must by approved by the French CNIL (Commission Nationale de l'Informatique et des Libertés : https://www.cnil.fr/professionnel) prior to access.
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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.
Arnaud BOURDIN principal investigator
a-bourdin@chu-montpellier.fr
18 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing 5 days of systemic corticotherapy (prednisone) in people with COPD Exacerbation, run by University Hospital, Montpellier at 18 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 6 inclusion and 21 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: stopped early, as of the sponsor's last update on 12 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 18 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study was stopped early (reason given: low enrollment at participating centers). Results are not available in the source record.
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?
Treatment failure (time frame: 3 months). 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 NCT04234360, which also lists 1 linked publication.
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 12 Jun 2026; AzTrials last refreshed its copy on 6 Nov 2026.