Efficacy and safety of Jia Wei Bushen Yiqi formulas as an adjunct therapy to systemic glucocorticoids on acute exacerbation of COPD: study protocol for a randomized, double-blinded, multi-center, placebo-controlled clinical trial.


Journal

Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253

Informations de publication

Date de publication:
03 Sep 2020
Historique:
received: 23 01 2020
accepted: 11 08 2020
entrez: 5 9 2020
pubmed: 5 9 2020
medline: 22 6 2021
Statut: epublish

Résumé

Systemic glucocorticoids are effective for the management of chronic obstructive pulmonary disease (COPD) exacerbation but have serious adverse effects. Traditional Chinese medicine (TCM) can bring additional benefits to these patients but has few adverse effects. The present study aims to evaluate the efficacy and safety of Jia Wei Bushen Yiqi (JWBY) formulas in patients who suffer from COPD exacerbations and to investigate whether the short-term (5-days) systemic glucocorticoid therapy is non-inferior to the long-term (9-day) regime. In this multi-center, randomized, double-blinded trial, eligible inpatients with COPD exacerbation are randomly assigned to four groups (A, B, C, and D). Group A will receive placebo plus 5-day prednisone, group B will receive placebo plus 9-day prednisone, group C will receive JWBY formulas plus 5-day prednisone, and group D will receive JWBY formulas plus 9-day prednisone. The primary outcomes are the time interval to the patient's next exacerbation during a 180-day following up and the COPD assessment test (CAT) during treatment. Secondary outcomes include lung function, TCM syndrome assessment, laboratory tests, and safety. The changes of the hypothalamic pituitary adrenaline axis (HPA axis) and inflammatory cytokine will be measured as well. By demonstrating the advantages of utilizing TCM and an appropriate duration of systemic glucocorticoids, this effectiveness comparison trial will provide new references to physicians on how to improve the management of COPD exacerbation. The results of HPA axis and inflammation cytokine measurements will shed light on the molecular mechanisms and entail further mechanism studies. www.chictr.org.cn ChiCTR1900023364. Registered on 24 May 2019.

Sections du résumé

BACKGROUND BACKGROUND
Systemic glucocorticoids are effective for the management of chronic obstructive pulmonary disease (COPD) exacerbation but have serious adverse effects. Traditional Chinese medicine (TCM) can bring additional benefits to these patients but has few adverse effects. The present study aims to evaluate the efficacy and safety of Jia Wei Bushen Yiqi (JWBY) formulas in patients who suffer from COPD exacerbations and to investigate whether the short-term (5-days) systemic glucocorticoid therapy is non-inferior to the long-term (9-day) regime.
METHODS METHODS
In this multi-center, randomized, double-blinded trial, eligible inpatients with COPD exacerbation are randomly assigned to four groups (A, B, C, and D). Group A will receive placebo plus 5-day prednisone, group B will receive placebo plus 9-day prednisone, group C will receive JWBY formulas plus 5-day prednisone, and group D will receive JWBY formulas plus 9-day prednisone. The primary outcomes are the time interval to the patient's next exacerbation during a 180-day following up and the COPD assessment test (CAT) during treatment. Secondary outcomes include lung function, TCM syndrome assessment, laboratory tests, and safety. The changes of the hypothalamic pituitary adrenaline axis (HPA axis) and inflammatory cytokine will be measured as well.
DISCUSSION CONCLUSIONS
By demonstrating the advantages of utilizing TCM and an appropriate duration of systemic glucocorticoids, this effectiveness comparison trial will provide new references to physicians on how to improve the management of COPD exacerbation. The results of HPA axis and inflammation cytokine measurements will shed light on the molecular mechanisms and entail further mechanism studies.
TRIAL REGISTRATION BACKGROUND
www.chictr.org.cn ChiCTR1900023364. Registered on 24 May 2019.

Identifiants

pubmed: 32883322
doi: 10.1186/s13063-020-04669-5
pii: 10.1186/s13063-020-04669-5
pmc: PMC7468179
doi:

Substances chimiques

Glucocorticoids 0

Types de publication

Clinical Trial Protocol Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

760

Subventions

Organisme : Three years to accelerate the development of Chinese medicine in Shanghai, China.
ID : ZY (2018-2020)-FWTX-4016
Organisme : China National Funds for Distinguished Young Scientists
ID : 81704154

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Auteurs

Qing Kong (Q)

Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China.

Shuming Mo (S)

Department of Integrative Medicine, North Hospital of Huashan Hospital, Fudan University, Shanghai, China.

Wenqian Wang (W)

Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China.

Zihui Tang (Z)

Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China.

Ying Wei (Y)

Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China.

Yijie Du (Y)

Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China.

Baojun Liu (B)

Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China.

Lingwen Kong (L)

Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China.

Yubao Lv (Y)

Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China. lvyubao80313@163.com.

Jingcheng Dong (J)

Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China. jingcheng_dong@yeah.net.

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