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Exercise Induced Laryngeal ObstructionNCT06480084

Prevalence of EILO Among Children With Asthma

A study testing Continuous Laryngoscopy during Exercise Test (CLE test) in people with Exercise Induced Laryngeal Obstruction and Asthma in Children, run by Medisch Spectrum Twente at 1 site 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 The sponsor has not verified this record for over two years, so it may be out of date.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

The goal of this cross-sectional study is to investigate the prevalence of Exercise Induced Laryngeal Obstruction (EILO) in children with asthma. The hypothesis is that the prevalence will be around 15%, which is higher than the prevalence of 5-8% among the general adolescent population. Read more about this study

Who is it for?
Ages 12 to 18 years
What is being tested?
Continuous Laryngoscopy during Exercise Test (CLE test)
How many people
200 participants
Where
1 siteNetherlands
Study dates
1 Aug 2024to 30 Apr 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 12 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Age 12 to 18 years
  • Paediatrician diagnosed asthma confirmed with at least one of the following during the last two years: Positive ECT (post-exercise fall in FEV1 > 10%) / Positive methacholine test (PC20 value of ≤8 mg/mL) / Bronchodilator reversibility (increase in FEV1 ≥12% and/or ≥200 mL following inhalation of 200-400 μg short-acting β2-agonists)

Who cannot join

  • Other severe cardiopulmonary disease
  • Inability to perform ECT or CLE test
  • Inability to perform technically acceptable spirometry
  • Asthma exacerbation or respiratory tract infection in the last 2 weeks
  • Short-acting β2-agonists or long-acting β2-agonists use less than respectively 8 and 24 hours before the ECT or CLE test
  • Oral corticosteroid use in the 4 weeks before the ECT or CLE test

Trial locations and contacts

1 site in 1 country.

Vera Hengeveld, MD contact

+31 53 487 23 10

vera.hengeveld@mst.nl

Mattienne van der Kamp, PhD contact

+31 53 487 23 10

m.vanderkamp@mst.nl

Netherlands1 site
  • Medisch Spectrum Twente

    Enschede, Overijssel, 7512 KZ

Other trials in Netherlands

About this study

Official title: The Prevalence of Exercise-Induced Laryngeal Obstruction (EILO) Amongst Children With Asthma' - a Prospective Cross-sectional Study

The goal of this cross-sectional study is to investigate the prevalence of Exercise Induced Laryngeal Obstruction (EILO) in children with asthma.

The hypothesis is that the prevalence will be around 15%, which is higher than the prevalence of 5-8% among the general adolescent population. This is based on the increased prevalence of EILO among adult asthmatics.

Participants who are referred for an Exercise Challenge Test will perform an additional Continuous Laryngoscopy during Exercise Test with expiratory FEV1 curves, and fill in the Borg scale for dyspnea, Asthma Control Test, EILODI questionnaire and DISCO-RC questionnaire.

Read the detailed description

Background:Exertional dyspnoea is a common and limiting symptom within the paediatric population. Regular physical activity is paramount for the development of children since it not only promotes cardiorespiratory fitness and muscle strength, but also offers opportunities for self-expression, building confidence and social interaction and integration. It is therefore important to identify the correct cause(s) of exertional dyspnea and reverse them to enable children to be active without symptoms.

Exercise induced bronchoconstriction (EIB) is a well-known cause of exertional dyspnoea and is highly specific of childhood asthma. Another less recognized cause of exertional dyspnoea is exercise induced laryngeal obstruction (EILO). EILO is an inappropriate closure of the larynx during strenuous physical activity with no obvious laryngeal pathology at rest, limiting airflow and causing inspiratory stridor. It can co-exist with and mimic symptoms of EIB.

Previous studies showed a prevalence of 6% in adolescent populations). However, recent studies revealed a much higher prevalence ofEILO in adults with asthma, up to 25-47%. The prevalence of EILO amongst children with asthma has not yet been investigated. In this study, the aim is to investigate the prevalence of EILO in children with asthma.

If EILO is a significant comorbidity of childhood asthma this would implicate that EILO screening should be considered when exercise is a persistent trigger of symptoms in asthmatic children. Correct EILO diagnosis and treatment can lead to adequate treatment of EILO, and to prevention of overtreatment of asthma.

Methods: Participants who are referred for an Exercise Challenge Test will perform an additional Continuous Laryngoscopy during Exercise Test with expiratory FEV1 curves, and fill in the Borg scale for dyspnea, Asthma Control Test, EILODI questionnaire and DISCO-RC questionnaire.

Power analysis: The sample size is calculated based on an estimated prevalence and confidence interval, with a power of 80% and alpha of 0.05. When estimating a prevalence of 15% (CI 10-20%), which is 2 times higher than in the general population (30), this results in a sample size of 196 participants. This was rounded to 200 participants. Dropouts will be replaced until a total number of 200 participants completed both the ECT and CLE test.

Statistical analysis for primary outcome: The prevalence of EILO in the study population of adolescents with asthma will be calculated as a percentage with a 95% confidence interval. Baseline characteristics will be compared between participants and non-participants of the CLE test. If there are no significant differences between these groups, it can be assumed that participants represent the studied population. If there are significant differences in baseline characteristics, we will examine the correlation of these characteristics with EILO. An estimated prevalence of EILO will be calculated among the non-participants based on these correlations, and an estimated weighted average will be calculated of the prevalence of EILO among the studied population.

Being tested
Continuous Laryngoscopy during Exercise Test (CLE test)
Medical subject headings
Asthma, Exercise-Induced, Dyspnea, Laryngeal Diseases

What participants receive

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

  • Continuous Laryngoscopy during Exercise Test (CLE test)Diagnostic test

    A flexible fiberoptic laryngoscope (Olympus, Tokyo, Japan) is introduced directly through the nose or via a slightly modified Hans Rudolph facemask, and into the pharyngeal space. A modified Bruce protocol with a 60-second incremental intensity step is used (Appendix A) and heart rate is monitored. During the CLE test participants perform incremental exercise on a treadmill until symptom-limiting distress or exhaustion. Forced expiratory flow-volume loops are measured before, during and after the CLE test.

What is being measured

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

  1. Prevalence of EILO

    Prevalence of EILO (defined as Maat score grade 2 or higher) in study population, with 95% confidence interval

    Measured: During CLE test. Measured in period until 200 participants are enrolled, expected to be 2 years

Secondary outcomes (27)
  1. Prevalence of EILO with and without current EIB

    The prevalence of EILO among adolescents with and without current EIB will be calculated using a 2x2 table, including 95% confidence intervals. These prevalences will be compared with a Chi-Square test or Fisher's exact test.

    Measured: During CLE test which takes approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  2. Association of gender with presence of EILO

    Baseline characteristics of adolescents with and without EILO will be compared. Association of gender with presence of EILO will be compared using a Chi-square or Fisher's exact test for categorical variables.

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  3. Association of age with presence of EILO

    Baseline characteristics of adolescents with and without EILO will be compared. Association of age with presence of EILO will be compared using a T-test (or non-parametric Mann Whitney U test) for continuous variables

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  4. Association of length with presence of EILO

    Baseline characteristics of adolescents with and without EILO will be compared. Association of length with presence of EILO will be compared using a T-test (or non-parametric Mann Whitney U test) for continuous variables

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  5. Association of weight with presence of EILO

    Baseline characteristics of adolescents with and without EILO will be compared. Association of weight with presence of EILO will be compared using a T-test (or non-parametric Mann Whitney U test) for continuous variables

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  6. Association of BMI Z score with presence of EILO

    Baseline characteristics of adolescents with and without EILO will be compared. Association of BMI Z score with presence of EILO will be compared using a T-test (or non-parametric Mann Whitney U test) for continuous variables

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  7. Association of hours of moderate-to-vigorous weekly activity with presence of EILO

    Baseline characteristics of adolescents with and without EILO will be compared. Association of hours of moderate-to-vigorous weekly activity with presence of EILO will be compared using a T-test (or non-parametric Mann Whitney U test) for continuous variables

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  8. Association of athletic performance (none/local/regional/national/international) with presence of EILO

    Baseline characteristics of adolescents with and without EILO will be compared. Association of athletic performance (none/local/regional/national/international) with presence of EILO will be compared using a Chi-square or Fisher's exact test for categorical variables.

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  9. Association of type of sports with presence of EILO

    Baseline characteristics of adolescents with and without EILO will be compared. Association of type of sports with presence of EILO will be compared using a Chi-square or Fisher's exact test for categorical variables.

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  10. Association of medication use with presence of EILO

    Baseline characteristics of adolescents with and without EILO will be compared. Association of medication use with presence of EILO will be compared using a Chi-square or Fisher's exact test for categorical variables.

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  11. Association of comorbidities with presence of EILO

    Baseline characteristics of adolescents with and without EILO will be compared. Association of comorbidities with presence of EILO will be compared using a Chi-square or Fisher's exact test for categorical variables.

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  12. Association of recognizable symptoms with presence of EILO

    Test characteristics of adolescents with and without EILO will be compared. Association of of recognizable symptoms with presence of EILO will be compared using a Chi-square or Fisher's exact test for categorical variables.

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  13. Association of type of reported symptoms with presence of EILO

    Test characteristics of adolescents with and without EILO will be compared. Association of of type of reported symptoms with presence of EILO will be compared using a Chi-square or Fisher's exact test for categorical variables.

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  14. Association of heart rate during exercise with presence of EILO

    Test characteristics of adolescents with and without EILO will be compared. Association of of heart rate during the exercise test with presence of EILO will be compared using a T-test (or non-parametric Mann Whitney U test)

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  15. Association of baseline FEV1 (% predicted) with presence of EILO

    Test characteristics of adolescents with and without EILO will be compared. Association of of baseline FEV1 (% predicted) with presence of EILO will be compared using a T-test (or non-parametric Mann Whitney U test)

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  16. Association of maximal % post-exercise fall in FEV1 with presence of EILO

    Test characteristics of adolescents with and without EILO will be compared. Association of of maximal % post-exercise fall in FEV1 with presence of EILO will be compared using a T-test (or non-parametric Mann Whitney U test)

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  17. Association of maximal exercise intensity (wattage/kg or maximum running pace and slope) with presence of EILO

    Test characteristics of adolescents with and without EILO will be compared. Exercise intensity will be measured by wattage/kg or maximum running pace and slope and categorized into poor / average / good. Association of of exercise intensity with presence of EILO will be compared using a Chi-square or Fisher's exact test for categorical variables

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  18. Association of Asthma Control Test (ACT) with EILO

    The ACT score and sub scores will be compared between adolescents with and without EILO using a T-test (or non-parametric Mann-Whitney U test). A receiver operating characteristic curve and 2x2 tables will be used to evaluate the sensitivity and specificity of different cut-off points of these questionnaires.

    Measured: During CLE test which takes approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  19. Association of Exercise-Induced Laryngeal Obstruction Dyspnea Index (EILODI) with EILO

    EILODI score and sub scores will be compared between adolescents with and without EILO using a T-test (or non-parametric Mann-Whitney U test). A receiver operating characteristic curve and 2x2 tables will be used to evaluate the sensitivity and specificity of different cut-off points of these questionnaires.

    Measured: During CLE test which takes approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  20. Association of Visual Analogue Scale (VAS) with EILO

    VAS scores will be compared between adolescents with and without EILO using a T-test (or non-parametric Mann-Whitney U test). A receiver operating characteristic curve and 2x2 tables will be used to evaluate the sensitivity and specificity of different cut-off points of these questionnaires.

    Measured: During CLE test which takes approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  21. Association of combination of questionnaire scores (Asthma Control Test (ACT), Exercise-Induced Laryngeal Obstruction Dyspnea Index (EILODI) and/or Visual Analogue Scale (VAS)) with EILO

    Questionnaire scores (ACT, EILODI, and/or VAS) and sub scores will be compared between adolescents with and without EILO using a T-test (or non-parametric Mann-Whitney U test). A receiver operating characteristic curve and 2x2 tables will be used to evaluate the sensitivity and specificity of different cut-off points of these questionnaires.

    Measured: During CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  22. Assesment of EIB with CLE compared to ECT test

    Lung function measurements during the CLE test will be compared to lung function measurements during the ECT using a Bland-Altman plot. A 2x2 table will be made of EIB presence during the ECT and CLE test and outcomes will be compared using a Chi-Square test.

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  23. Comparison of age between participants with similar and non-similar EIB results during CLE and ECT test

    Age will be compared between participants with similar and non-similar results during the ECT and CLE test using a T-test, or a non-parametric Mann-Whitney U test

    Measured: During ECT and CLE test which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  24. Comparison of test duration between participants with similar and non-similar EIB results during CLE and ECT test

    Test duration will be compared between participants with similar and non-similar results during the ECT and CLE test using a T-test, or a non-parametric Mann-Whitney U test

    Measured: During ECT and CLE test, which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  25. Comparison of heart rate between participants with similar and non-similar EIB results during CLE and ECT test

    Heart rate will be compared between participants with similar and non-similar results during the ECT and CLE test using a T-test, or a non-parametric Mann-Whitney U test

    Measured: During ECT and CLE test, which each take approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  26. Inter-rater agreement of EILO diagnosis between two participating hospitals

    Inter-rater agreement of the presence of EILO and the Maat score of laryngoscopical images of the larynx, between both hospitals will be described using Cohen's weighted x.

    Measured: During CLE test, which takes approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

  27. Self-reported discomfort of CLE test

    The self-reported discomfort during the CLE test will be calculated based on the DISCO-RC questionnaire scores.

    Measured: After the CLE test, which takes approximately one hour. Measured in period until 200 participants are enrolled, expected to be 2 years

Timeline

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

  1. First posted28 Jun 2024
  2. Study start1 Aug 2024 (estimated)
  3. Primary completion1 Apr 2026 (estimated)
  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
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Not applicable
Intervention model
Single group
Model description
cross-sectional study
Masking
None (open label)
Enrolment
200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06480084
Sponsor's protocol ID
Prevalence EILO
Status last verified
Jun 2024
First submitted
12 Feb 2024
Last updated
28 Jun 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Continuous Laryngoscopy during Exercise Test (CLE test) in people with Exercise Induced Laryngeal Obstruction and Asthma in Children, run by Medisch Spectrum Twente at 1 site 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 2 inclusion and 6 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 28 Jun 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 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 Vera Hengeveld, MD (+31 53 487 23 10, vera.hengeveld@mst.nl), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Prevalence of EILO (time frame: During CLE test. Measured in period until 200 participants are enrolled, expected to be 2 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 28 Jun 2024.

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