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COPD ExacerbationDICENCT04961060

Drivers of Eosinophilic COPD Exacerbations

An observational study of COPD Exacerbation and Eosinophilia, run by University Medical Center Groningen at 2 sites in Netherlands.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

Main objective: investigate gene expression differences in nasal epithelium and sputum between eosinophilic COPD exacerbations and other subtypes. Read more about this study

Who is it for?
Ages 40 years and older
Conditions the study is for
COPD Exacerbation, Eosinophilia
How many people
100 participants
Where
2 sitesNetherlands
Study dates
Jul 2021to Jan 2025
Phase
Observational
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Patients admitted to the UMCG or MUMC for a COPD exacerbation.

Who may be able to join

  • COPD patient admitted to the hospital for an acute exacerbation of COPD
  • Physician diagnosed COPD according to the GOLD 2020 guidelines, including symptoms consistent with COPD, post-bronchodilator FEV1 < 80% predicted and FEV1/FVC < 70%.
  • Age > 40 years.
  • Smoker or ex-smoker, ≥ 10 pack years of smoking.

Who cannot join

  • Current asthma, or prior physician diagnosis of asthma without a symptom- free interval of at least 10 years before the age of 40.
  • Chronic use of prednisolone.
  • Use of systemic corticosteroids ≥4 days prior to hospital admission.
  • Necessity (upon hospitalization) for non-invasive ventilation or ICU admission.
  • Pneumonia at presentation documented by chest roentgenography.
  • Any other clinically relevant lung disease deemed to interfere with the concept of the study design.
Show all 15Show fewer
  • Allergy to systemic corticosteroids or to antibiotics.
  • Females of childbearing potential without an efficient contraception unless they meet the following definition of post-menopausal: 12 months of natural (spontaneous) amenorrhea or 6 months of spontaneous amenorrhea with serum FSH >40 mIU/mL or the use of one or more of the following acceptable methods of contraception:
  • Surgical sterilization (e.g. bilateral tubal ligation, hysterectomy).
  • Hormonal contraception (implantable, patch, oral, injectable).
  • Barrier methods of contraception: condom or occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/cream/suppository.
  • Continuous abstinence
  • Pregnancy or lactation.
  • Known immunodeficiency.
  • Life expectancy less than 60 days

Trial locations and contacts

2 sites in 1 country.

Lisa H van Smoorenburg, MSc. contact

+3150 361 6102

l.h.van.smoorenburg@umcg.nl

Maarten van den Berge, PhD contact

+3150 361 52 60

m.van.den.berge@umcg.nl

Netherlands2 sites, 2 recruiting
  • Univesity Medical Center Groningen

    Groningen, 9713 GZ

    Lisa H van Smoorenburg, MSc., +3150 361 6102, l.h.van.smoorenburg@umcg.nl

    Maarten van den Berge, PhD, +3150 361 52 60, m.van.den.berge@umcg.nl

    Recruiting
  • University Maastricht

    Maastricht, Limburg, 6229 GT

    Sami O Simons, PhD, +3143 387 55 00, sami.simons@mumc.nl

    Not yet recruiting

Other trials in Netherlands

About this study

Main objective: investigate gene expression differences in nasal epithelium and sputum between eosinophilic COPD exacerbations and other subtypes.

Read the detailed description

Main objective: investigate gene expression differences in nasal epithelium and sputum between eosinophilic COPD exacerbations and other subtypes to better understand why some patients are more at risk for eosinophilic COPD exacerbations. Secondary objectives:

  1. Investigate differences in microbiome composition and immunophenotyping profiles in peripheral blood per subtype.
  2. Assess for clinical differences between all COPD exacerbation subtypes.
  3. Assess if and how baseline meta-transcriptomics either in nasal epithelium or sputum and blood immunophenotyping can be utilized to predict COPD exacerbation subtype.
  4. Determine if the microbiome in sputum and nasal epithelial material are comparable.
  5. Determine if different subtypes of COPD exacerbations respond differently to standard treatment with oral prednisolone (40 mg daily) with or without antibiotics.
  6. To evaluate if metabolic responses during recovery are different in patients with increased systemic inflammation compared to patients without systemic inflammation at exacerbation
Medical subject headings
Eosinophilia

What participants receive

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

Study groups in NCT04961060
Study groupRoleWhat they receive
Eosinophilic exacerbationCOPD exacerbation associated with eosinophilia.
Viral exacerbationCOPD exacerbation associated with viral infection.
Bacterial exacerbationCOPD exacerbation associated bacterial infection.
Pauci-inflammatory exacerbationPauci-inflammatory COPD exacerbation

What is being measured

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

  1. Change in gene expression profiles in sputum by RNA sequencing

    Change in gene expression profiles in sputum between the four groups using RNA sequencing. The differences between the expression levels of transcripts (counts) will be analyzed.

    Measured: At admission and after 6-8 weeks after discharge.

  2. Change in gene expression profiles in nasal epithelium by using RNA sequencing

    Change in gene expression profilesin nasal epithelium between the four groups using RNA sequencing. The differences between the expression levels of transcripts (counts) will be analyzed.

    Measured: At admission and after 6-8 weeks after discharge.

Secondary outcomes (6)
  1. Microbiome composition in sputum by using RNA sequencing.

    Differences in microbiome composition in sputum between the four groups by using RNA sequencing.

    Measured: At admission, at day 5 of admission and 6-8 weeks after discharge.

  2. Phenotype blood cell population by flow cytometry.

    Differences in blood cell population between the four groups as measured by flow cytometry.

    Measured: At admission, at day 5 of admission and 6-8 weeks after discharge.

  3. Phenotypic analysis of the T cell compartment by staining of whole blood or isolated peripheral blood mononuclear cells using antibodies

    Differences in the T cell compartment between the four groups by staining of whole blood or isolated peripheral blood mononuclear cells using antibodies.

    Measured: At admission, at day 5 of admission and 6-8 weeks after discharge.

  4. Comparison of microbiome composition in sputum and nasal epithelial material by RNA sequencing.

    Measure microbiome composition in sputum and nasal epithelium by RNA sequencing. Compare them by the bacterial taxa which are significantly different between groups

    Measured: At admission and 6-8 weeks after discharge.

  5. Clinical differences between groups by the COPD Assessment Test (CAT).

    Differences in number of participants per group with a high impact of COPD related symptoms as assessed by the CAT.

    Measured: Every day of hospital admission.

  6. Clinical differences between groups by peak flow measurements.

    Differences in number of participants per group with a low peak expiratory flow rate as measured by a handheld peak flow meter.

    Measured: Every day of hospital admission.

Timeline

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

  1. First posted14 Jul 2021
  2. Study startJul 2021 (estimated)
  3. Primary completionSep 2024 (estimated)
  4. Study completionJan 2025 (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
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04961060
Sponsor's protocol ID
NL75151.042.20
Acronym
DICE
Status last verified
Jul 2021
First submitted
28 Apr 2021
Last updated
14 Jul 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Wang Z, Singh R, Miller BE, Tal-Singer R, Van Horn S, Tomsho L, Mackay A, Allinson JP, Webb AJ, Brookes AJ, George LM, Barker B, Kolsum U, Donnelly LE, Belchamber K, Barnes PJ, Singh D, Brightling CE, Donaldson GC, Wedzicha JA, Brown JR; COPDMAP. Sputum microbiome temporal variability and dysbiosis in chronic obstructive pulmonary disease exacerbations: an analysis of the COPDMAP study. Thorax. 2018 Apr;73(4):331-338. doi: 10.1136/thoraxjnl-2017-210741. Epub 2017 Dec 21.

    PubMed 29269441
  • Bafadhel M, McKenna S, Terry S, Mistry V, Reid C, Haldar P, McCormick M, Haldar K, Kebadze T, Duvoix A, Lindblad K, Patel H, Rugman P, Dodson P, Jenkins M, Saunders M, Newbold P, Green RH, Venge P, Lomas DA, Barer MR, Johnston SL, Pavord ID, Brightling CE. Acute exacerbations of chronic obstructive pulmonary disease: identification of biologic clusters and their biomarkers. Am J Respir Crit Care Med. 2011 Sep 15;184(6):662-71. doi: 10.1164/rccm.201104-0597OC.

    PubMed 21680942
  • Mayhew D, Devos N, Lambert C, Brown JR, Clarke SC, Kim VL, Magid-Slav M, Miller BE, Ostridge KK, Patel R, Sathe G, Simola DF, Staples KJ, Sung R, Tal-Singer R, Tuck AC, Van Horn S, Weynants V, Williams NP, Devaster JM, Wilkinson TMA; AERIS Study Group. Longitudinal profiling of the lung microbiome in the AERIS study demonstrates repeatability of bacterial and eosinophilic COPD exacerbations. Thorax. 2018 May;73(5):422-430. doi: 10.1136/thoraxjnl-2017-210408. Epub 2018 Jan 31.

    PubMed 29386298
  • Imkamp K, Berg M, Vermeulen CJ, Heijink IH, Guryev V, Kerstjens HAM, Koppelman GH, van den Berge M, Faiz A. Nasal epithelium as a proxy for bronchial epithelium for smoking-induced gene expression and expression Quantitative Trait Loci. J Allergy Clin Immunol. 2018 Jul;142(1):314-317.e15. doi: 10.1016/j.jaci.2018.01.047. Epub 2018 Mar 6. No abstract available.

    PubMed 29522853
  • Boudewijn IM, Lan A, Faiz A, Cox CA, Brouwer S, Schokker S, Vroegop SJ, Nawijn MC, Woodruff PG, Christenson SA, Hagedoorn P, Frijlink HW, Choy DF, Brouwer U, Wisman M, Postma DS, Fingleton J, Beasley R, van den Berge M, Guryev V. Nasal gene expression changes with inhaled corticosteroid treatment in asthma. Allergy. 2020 Jan;75(1):191-194. doi: 10.1111/all.13952. Epub 2019 Jul 15. No abstract available.

    PubMed 31230369
  • Liesker JJ, Bathoorn E, Postma DS, Vonk JM, Timens W, Kerstjens HA. Sputum inflammation predicts exacerbations after cessation of inhaled corticosteroids in COPD. Respir Med. 2011 Dec;105(12):1853-60. doi: 10.1016/j.rmed.2011.07.002. Epub 2011 Jul 29.

    PubMed 21802933
  • Caramori G, Casolari P, Barczyk A, Durham AL, Di Stefano A, Adcock I. COPD immunopathology. Semin Immunopathol. 2016 Jul;38(4):497-515. doi: 10.1007/s00281-016-0561-5. Epub 2016 May 13.

    PubMed 27178410
  • Brusselle GG, Joos GF, Bracke KR. New insights into the immunology of chronic obstructive pulmonary disease. Lancet. 2011 Sep 10;378(9795):1015-26. doi: 10.1016/S0140-6736(11)60988-4.

    PubMed 21907865
  • Zhu J, Paul WE. Peripheral CD4+ T-cell differentiation regulated by networks of cytokines and transcription factors. Immunol Rev. 2010 Nov;238(1):247-62. doi: 10.1111/j.1600-065X.2010.00951.x.

    PubMed 20969597
  • Travers J, Rothenberg ME. Eosinophils in mucosal immune responses. Mucosal Immunol. 2015 May;8(3):464-75. doi: 10.1038/mi.2015.2. Epub 2015 Mar 25.

    PubMed 25807184
  • Aguirre-Gamboa R, Joosten I, Urbano PCM, van der Molen RG, van Rijssen E, van Cranenbroek B, Oosting M, Smeekens S, Jaeger M, Zorro M, Withoff S, van Herwaarden AE, Sweep FCGJ, Netea RT, Swertz MA, Franke L, Xavier RJ, Joosten LAB, Netea MG, Wijmenga C, Kumar V, Li Y, Koenen HJPM. Differential Effects of Environmental and Genetic Factors on T and B Cell Immune Traits. Cell Rep. 2016 Nov 22;17(9):2474-2487. doi: 10.1016/j.celrep.2016.10.053. Epub 2016 Nov 3.

    PubMed 27818087
  • Narendra DK, Hanania NA. Targeting IL-5 in COPD. Int J Chron Obstruct Pulmon Dis. 2019 May 16;14:1045-1051. doi: 10.2147/COPD.S155306. eCollection 2019.

    PubMed 31190789
  • Ditz B, Christenson S, Rossen J, Brightling C, Kerstjens HAM, van den Berge M, Faiz A. Sputum microbiome profiling in COPD: beyond singular pathogen detection. Thorax. 2020 Apr;75(4):338-344. doi: 10.1136/thoraxjnl-2019-214168. Epub 2020 Jan 29.

    PubMed 31996401
  • Gao P, Gibson PG, Zhang J, He X, Hao Y, Li P, Liu H. The safety of sputum induction in adults with acute exacerbation of COPD. Clin Respir J. 2013 Jan;7(1):101-9. doi: 10.1111/j.1752-699X.2012.00291.x. Epub 2012 Apr 23.

    PubMed 22452898
  • Pavord ID, Chanez P, Criner GJ, Kerstjens HAM, Korn S, Lugogo N, Martinot JB, Sagara H, Albers FC, Bradford ES, Harris SS, Mayer B, Rubin DB, Yancey SW, Sciurba FC. Mepolizumab for Eosinophilic Chronic Obstructive Pulmonary Disease. N Engl J Med. 2017 Oct 26;377(17):1613-1629. doi: 10.1056/NEJMoa1708208. Epub 2017 Sep 11.

    PubMed 28893134

Questions about this trial

What is this clinical trial studying?

An observational study of COPD Exacerbation and Eosinophilia, run by University Medical Center Groningen at 2 sites in Netherlands.

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 15 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 14 Jul 2021. 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 Netherlands. 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 Lisa H van Smoorenburg, MSc. (+3150 361 6102, l.h.van.smoorenburg@umcg.nl), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in gene expression profiles in sputum by RNA sequencing (time frame: At admission and after 6-8 weeks after discharge.). The study lists 2 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 NCT04961060, which also lists 20 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 14 Jul 2021.

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