In this study the efficacy of Roflumilast in addition to LAMA/LABA therapy will be assessed using Functional Respiratory Imaging. In total 40 Chronic obstructive pulmonary disease (COPD) patients, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages C and D, who are stable on LABA/LAMA therapy and who are prone to dynamics hyperinflation will be included in this study. To indicate the susceptibility to dynamics hyperinflation patients should have a baseline Borg Fatigue score after the 6-minute walk test (6MWT) above 4. The patients will be randomized in such a way that 1 out of 2 patients will receive placebo and 1 the active component. Image parameters will be assessed and the correlation with lung function and health related quality of life will be checked before and after treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
13
HRCT scan of thorax, at baseline and after 3 months
Placebo, once a day in the morning during 3 months
Roflumilast, once a day in the morning during 3 months
University Hospital of Antwerp
Edegem, Antwerp, Belgium
Changes in Airway volume (iVaw)
By using Functional Respiratory Imaging the efficacy of Roflumilast in addition to long-acting muscarinic antagonist (LAMA)/ long acting β2-agonist (LABA) therapy will be assessed.
Time frame: At baseline and after 3 months of treatment
Changes in Airway resistance (iRaw)
By using Functional Respiratory Imaging the efficacy of Roflumilast in addition to long-acting muscarinic antagonist (LAMA)/ long acting β2-agonist (LABA) therapy will be assessed.
Time frame: At baseline and after 3 months of treatment
Changes in Lobe volumes (iVlobes)
By using Functional Respiratory Imaging the efficacy of Roflumilast in addition to long-acting muscarinic antagonist (LAMA)/ long acting β2-agonist (LABA) therapy will be assessed.
Time frame: At baseline and after 3 months of treatment
Changes in Air trapping
By using Functional Respiratory Imaging the efficacy of Roflumilast in addition to long-acting muscarinic antagonist (LAMA)/ long acting β2-agonist (LABA) therapy will be assessed.
Time frame: At baseline and after 3 months of treatment
Changes in Internal Lobar Airflow Distribution
By using Functional Respiratory Imaging the efficacy of Roflumilast in addition to long-acting muscarinic antagonist (LAMA)/ long acting β2-agonist (LABA) therapy will be assessed.
Time frame: At baseline and after 3 months of treatment
Low Attenuation or Emphysema Score
By using Functional Respiratory Imaging the efficacy of Roflumilast in addition to long-acting muscarinic antagonist (LAMA)/ long acting β2-agonist (LABA) therapy will be assessed.
Time frame: At baseline and after 3 months of treatment
Changes in Blood Vessel Density
By using Functional Respiratory Imaging the efficacy of Roflumilast in addition to long-acting muscarinic antagonist (LAMA)/ long acting β2-agonist (LABA) therapy will be assessed.
Time frame: At baseline and after 3 months of treatment
Changes in Airway Wall Thickness
By using Functional Respiratory Imaging the efficacy of Roflumilast in addition to long-acting muscarinic antagonist (LAMA)/ long acting β2-agonist (LABA) therapy will be assessed.
Time frame: 3 months
Aerosol deposition concentrations
By using Functional Respiratory Imaging the efficacy of Roflumilast in addition to long-acting muscarinic antagonist (LAMA)/ long acting β2-agonist (LABA) therapy will be assessed.
Time frame: At baseline and after 3 months of treatment
Changes in Spirometry
Spirometry is a composite outcome measure consisting of the following parameters: * FEV1 * Peak Expiratory Flow (PEF) * Forced Vital Capacity (FVC) * Maximum Expiratory Flow at 50% of FVC (MEF 50) * Maximum Expiratory Flow at 25% of FVC (MEF 25)
Time frame: At baseline and after 3 months of treatment
Changes in Body plethysmography
Body plethysmography is a composite outcome measure consisting of the following parameters: * Residual Volume (RV) * TLC * FRC * Airway resistance (Raw)
Time frame: At baseline and after 3 months of treatment
Changes in Diffusion capacity
Diffusion capacity is a composite outcome measure consisting of the following parameters: * carbon monoxide transfer factor (TCO) * Alveolar volume (VA)
Time frame: At baseline and after 3 months of treatment
Changes in 6MWT
Exercise capacity: distance walked in 6 minutes (m), oxygen saturation measurement will be performed during the test
Time frame: At baseline and after 3 months of treatment
Changes in Patient Related Outcome (PRO)
Patient Related Outcome is a composite outcome measure consisting of the following questionnaires: * Borg CR10 Scale: measure of the present dyspnea and leg fatigue before and after exercise * COPD assessment test (CAT): measure of the impact of COPD on your life * Saint George's Respiratory Questionnaire (SGRQ): measure health related quality of life and comfort
Time frame: At baseline and after 3 months of treatment
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