Efficacy of ICS-Formoterol Maintenance at Initial Treatment with Sequential Anti-Inflammation Reliever Therapy in Newly Diagnosed Mild Asthma Patients: A Randomized, Parallel, Positive-Control Study
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注册号: Registration number: |
ChiCTR2400088138 |
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最近更新日期: Date of Last Refreshed on: |
2024-08-12 17:31:43 |
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注册时间: Date of Registration: |
2024-08-12 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
初诊轻度支气管哮喘患者初始规律ICS-福莫特罗序贯按需治疗的疗效:随机、平行、阳性对照研究 |
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Public title: |
Efficacy of ICS-Formoterol Maintenance at Initial Treatment with Sequential Anti-Inflammation Reliever Therapy in Newly Diagnosed Mild Asthma Patients: A Randomized, Parallel, Positive-Control Study |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
初诊轻度支气管哮喘患者规律ICS/LABA序贯按需治疗的疗效:随机、平行、阳性对照研究 |
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Scientific title: |
Efficacy of Regular ICS/LABA Sequential As-Needed Therapy in Newly Diagnosed Mild Asthma Patients: A Randomized, Parallel, Positive-Control Study |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
周妍 |
研究负责人: |
周妍 |
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Applicant: |
Zhou Yan |
Study leader: |
Yan Zhou |
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申请注册联系人电话: Applicant telephone: |
+86 18964705743 |
研究负责人电话: Study leader's telephone: |
+86 21 63240090 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
zhouyan790304@163.com |
研究负责人电子邮件: Study leader's E-mail: |
zhouyan790304@163.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
上海市虹口区武进路85号 |
研究负责人通讯地址: |
武进路85/86号 |
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Applicant address: |
No. 85, Wujin Road, Hongkou District Shanghai, China, 200080. |
Study leader's address: |
No. 85/86 Wujin Road, Hongkou District, Shanghai |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
上海市第一人民医院呼吸与危重症医学科 |
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Applicant's institution: |
Department of Respiratory and Critical Care Medicine, Shanghai General Hospital |
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研究负责人所在单位: |
上海市第一人民医院 |
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Affiliation of the Leader: |
Shanghai General Hospital |
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是否获伦理委员会批准: |
是/Yes |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
院伦审【2024】110号 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
上海市第一人民医院人体试验伦理审查委员会 |
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Name of the ethic committee: |
Shanghai General Hospital Institutional Review Board |
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伦理委员会批准日期: Date of approved by ethic committee: |
2024-07-17 00:00:00 |
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伦理委员会联系人: |
耿雯倩 |
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Contact Name of the ethic committee: |
Geng Wenqian |
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伦理委员会联系地址: |
武进路85/86号 |
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Contact Address of the ethic committee: |
No. 85/86 Wujin Road, Hongkou District, Shanghai |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 21 36126254 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
13262983906@163.com |
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研究实施负责(组长)单位: |
上海市第一人民医院 |
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Primary sponsor: |
Shanghai General Hospital |
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研究实施负责(组长)单位地址: |
武进路85/86号 |
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Primary sponsor's address: |
No. 85/86 Wujin Road, Hongkou District, Shanghai |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
上海市第一人民医院 特色研究项目计划 面上项目;中华国际医学交流基金会-呼吸疾病青年实用研究项目 |
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Source(s) of funding: |
Clinical Research Innovation Plan of Shanghai General Hospital;China International Medical Foundation-Practical Research Project on Respiratory Diseases |
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Target disease: |
mild bronchial asthma |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
IV期临床试验 | ||||||||||||||||||||||
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Study phase: |
4 |
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研究设计: |
随机平行对照 |
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Study design: |
Parallel |
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研究目的: |
1、评价初诊轻度支气管哮喘初始治疗时给予4周维持低剂量ICS/LABA对比按需低剂量ICS/LABA在轻度哮喘患者中的疗效,明确4周FEV1较基线改善情况,及对气道可逆性及气道炎症水平的改善,确立药物疗效的最佳人群和最佳治疗方案; 2、基于肺功能全参数(大气道参数:FEV1, FEV1/FVC;峰流速:PEF;小气道参数:FEF25%, FEF50%, FEF75%, MMEF)和气道炎症水平等多维评估,探索可有效预测维持低剂量ICS/LABA治疗在轻度初诊哮喘患者中疗效的生物标志物; 3、初始维持低剂量ICS/LABA治疗4W,后续按需该药物治疗至24W,对比初始即按需低剂量ICS/LABA治疗至24W,在24W研究中引入移动肺功能,动态监测大小气道功能全参数及临床指标,探索早期维持低剂量ICS/LABA+后续按需治疗在轻度哮喘中对FEV1较基线改善率、急性发作风险指标、气道炎症影响,并建立急性发作预测模型。 |
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Objectives of Study: |
1.Evaluate the efficacy of 4 weeks of maintenance therapy with low-dose ICS/LABA versus as-needed low-dose ICS/LABA in newly diagnosed mild asthma patients. Assess the improvement in FEV1 from baseline over 4 weeks, and the impact on airway reversibility and inflammation levels. Identify the optimal patient population and treatment regimen for the medication. 2.Based on a comprehensive evaluation of pulmonary function parameters (including large airway parameters: FEV1, FEV1/FVC; peak flow: PEF; small airway parameters: FEF25%, FEF50%, FEF75%, MMEF) and airway inflammation levels, explore biomarkers that can effectively predict the efficacy of maintenance therapy with low-dose ICS/LABA in newly diagnosed mild asthma patients. 3.Compare 4 weeks of initial maintenance therapy with low-dose ICS/LABA followed by as-needed medication until 24 weeks with as-needed low-dose ICS/LABA therapy until 24 weeks. In the 24-week study, incorporate mobile lung function monitoring to dynamically assess large and small airway function parameters and clinical indicators. Explore the impact of early maintenance therapy with low-dose ICS/LABA followed by as-needed treatment on FEV1 improvement from baseline, acute exacerbation risk indicators, and airway inflammation, and develop a model to predict acute exacerbations. |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1)受试者充分了解研究目的、性质及方法,自愿作为受试者,并在任何研究程序开始前签署知情同意书; 2)成人(包含男性和非孕期、非哺乳期女性)(18岁~70岁,包含边界值),根据国内最新版支气管哮喘防治指南,初次诊断为轻度且非急性发作期的支气管哮喘患者; 3)筛选期满足以下任意一项可变气流受限的客观检查:①支气管舒张试验阳性(吸入支气管舒张剂后,FEV1增加>12%,且FEV1绝对值增加>200 mL);②支气管激发试验阳性;吸入激发剂乙酰甲胆碱后FEV1下降≥20%,结果为阳性; 4)筛选期和导入期D-1访视时,肺功能检查FEV1占预计值%为>80%者; 5)受试者或监护人能够和研究者进行良好沟通,理解和遵守本研究的各项要求者。 |
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Inclusion criteria |
1)Participants fully understand the purpose, nature, and methods of the study, voluntarily agree to participate, and sign an informed consent form before any study procedures begin. 2) Adults (including males and non-pregnant, non-lactating females) aged 18 to 70 years (inclusive), who are newly diagnosed with mild and non-acute bronchial asthma according to the latest Chinese guidelines for the prevention and treatment of bronchial asthma. 3) During the screening period, participants must meet at least one of the following criteria for reversible airflow obstruction: Positive bronchodilator test (increase in FEV1 ≥12% and an absolute increase in FEV1 ≥200 mL after inhaling a bronchodilator); |
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排除标准: |
1)对布地奈德、福莫特罗、沙丁胺醇或任意药物组分过敏或不耐受者; 2)筛选前2个月内至随机前出现呼吸道感染、鼻窦感染或中耳感染,并引起哮喘治疗的改变或根据研究者的判断预期会引起受试者哮喘状态改变者; 3)筛选时有慢性阻塞性肺病、间质性肺病、限制性肺病、肺结核、囊性纤维化、支气管扩张或α1-抗胰蛋白酶缺乏症等病史者; 4)筛选时有重大疾病,如:充血性心力衰竭、不受控制的高血压、严重的冠状动脉疾病、心肌梗塞或严重的心律失常、或患有严重血液学、肝病、神经、肌肉骨骼、内分泌、代谢、精神病、肾病或其他病史。如果以上疾病在研究期间恶化,可能会因参加研究而使患者处于危险之中,或影响研究结果; 5)筛选期及导入期,曾经出现过1天吸入SABA超过8次者; 6)导入期内,使用过β受体阻滞剂治疗者(包括滴眼液)、接受了口服糖皮质激素治疗或进行了全身激素治疗、接受过研究药物治疗、使用过白三烯受体拮抗剂(如扎鲁司特、普鲁司特、孟鲁司特等)者; 7)既往吸烟,吸烟指数>10包年者; 8)筛选访视(访视1)前戒烟≤6个月或当前吸烟者; 9)已知或疑似酒精和/或药物滥用,酗酒即每日平均饮酒超过2单位酒精者(1单位=360mL啤酒或45mL酒精量为40%的白酒或150mL葡萄酒); 10)筛选时和导入期D-1访视时,患者存在生命体征、体格检查、12-导联心电图、胸部CT、血常规、尿常规、血生化、凝血功能等结果异常且有临床意义者,但经研究者判断与本研究疾病及伴随疾病等相关且不影响入组的受试者除外; 11)妊娠试验阳性或在哺乳期的女性受试者; 12)筛选前1个月内使用可能会与研究药物发生相互作用的药物,如CYP3A4抑制剂(酮康唑、伊曲康唑)、西咪替丁、双硫仑、甲硝唑等或CYP3A4酶强诱导剂(如利福平、卡马西平、苯妥英钠等); 13)筛选前1个月内参加过其它医疗器械临床试验或/和筛选前3个月内参加过其它药物临床试验者; 14)随机前一周哮喘总症状(日间+夜间)评分<2分; 15)不能依从研究程序或经研究者判断不宜参加研究的患者。 |
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Exclusion criteria: |
1.Here is the translation of the exclusion criteria: 1). Individuals allergic or intolerant to budesonide, formoterol, albuterol, or any component of the medication. 2). Respiratory, sinus, or middle ear infections within the 2 months prior to screening or up to randomization that led to a change in asthma treatment, or are expected to alter the participant's asthma status according to the investigator's judgment. 3). History of chronic obstructive pulmonary disease (COPD), interstitial lung disease, restrictive lung disease, tuberculosis, cystic fibrosis, bronchiectasis, or alpha-1 antitrypsin deficiency at screening. 4). History of major diseases at screening, such as congestive heart failure, uncontrolled hypertension, severe coronary artery disease, myocardial infarction, or severe arrhythmias, or severe hematological, hepatic, neurological, musculoskeletal, endocrine, metabolic, psychiatric, renal, or other significant conditions. If any of these conditions worsen during the study, it may endanger the participant or affect study results. 5). Excessive use of short-acting beta-agonists (SABA), defined as more than 8 inhalations per day, during the screening period and the run-in period. 6). Use of beta-blockers (including eye drops), oral corticosteroids, systemic steroid treatments, investigational drugs, or leukotriene receptor antagonists (such as zafirlukast, pranlukast, montelukast, etc.) during the run-in period. 7). History of smoking with a smoking index >10 pack-years. 8). Smoking cessation ≤6 months before the screening visit (Visit 1) or current smokers. 9). Known or suspected alcohol and/or drug abuse, including heavy drinking (average daily consumption >2 units of alcohol, where 1 unit = 360 mL of beer, 45 mL of 40% alcohol, or 150 mL of wine). 10). Abnormal and clinically significant results in vital signs, physical examination, 12-lead ECG, chest CT, blood tests, urinalysis, blood biochemistry, or coagulation tests at screening and the Day -1 visit, unless judged by the investigator to be related to the study condition and not affecting inclusion. 11). Pregnant or breastfeeding females. 12). Use of medications that may interact with the study drug within 1 month before screening, such as CYP3A4 inhibitors (e.g., ketoconazole, itraconazole), cimetidine, disulfiram, metronidazole, or CYP3A4 enzyme inducers (e.g., rifampin, carbamazepine, phenytoin). 13). Participation in other medical device clinical trials within 1 month before screening or other drug clinical trials within 3 months before screening. 14). Asthma total symptom score (daytime + nighttime) <2 points in the week prior to randomization. 15). Patients who cannot comply with the study procedures or who, in the investigator's judgment, are not suitable for participation in the study. |
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研究实施时间: Study execute time: |
从 From 2024-07-25 00:00:00至 To 2027-09-30 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2024-08-12 00:00:00 至 To 2027-09-30 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
利用中央随机化系统实施随机化过程 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
Implement randomization process using central randomization system |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
不公开/Private |
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盲法: |
单盲,对评估者隐藏分组 |
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Blinding: |
Single blind study with blinded-evaluators |
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是否共享原始数据: IPD sharing |
No |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
2028-01,公开协议及数据 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
include metadata and protocol |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
病例记录表及电子采集和管理系统 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
case record form and electronic data capture |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
无/No |