The present study will aim to find out whether a home treatment in people with bronchiectasis consisting of a single daily session to facilitate expectoration (combining nebulization of hypertonic saline (HS) at 6% followed by airway clearance techniques) is at least as effective as performing two sessions per day following the same process in each of the sessions, during a period of 6 months.
A non-inferiority randomised clinical trial (single-blind) will be conducted. At least 50 participants will be recruited from the outpatient clinics of the Hospital Clinic in Barcelona and the Clinical University Hospital in Zaragoza. The experimental group will nebulize once/day the hypertonic saline (HS) solution followed by airway clearance exercises (15 min) for 6 months. The control group will follow the same procedure, but the frequency of the sessions will be twice a day (reference as usual clinical practice). The main study outcomes will be: (1) cough severity (primary endpoint), symptoms and quality of life; (2) functional exercise capacity; (3) time to first exacerbation and total number of exacerbations; (4) indirect measures of mucociliary transport (rheology and concentration of solids in sputum samples); (5) inflammatory parameters; (5) tolerance, safety and adherence to treatment. Measurements will be taken at baseline (prior to randomization), at 1 month, 3 months, and 6 months. Finally, hypothesis testing will be performed using a linear mixed model (2x3) of repeated measures, establishing a priori a margin of non-inferiority.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
50
Participants will start the sessions by inhaling a short-acting bronchodilator or an anticholinergic to avoid the presence of bronchospasm during nebulisation. The hypertonic solution (at 6%) will be administered through the Turbo Boy nebuliser (Pari®). The intervention will take place at home.
Following nebulisation, participants will perform airway clearance techniques using an oscillating positive expiratory pressure device for at least 15 minutes. The intervention will take place at home
Hospital Clinic
Barcelona, Spain
Beatriz Herrero Cortina
Zaragoza, Spain
Impact of coughing on quality of life
The Leicester Cough Questionnaire (LCQ) will be used to assess the daily cough impact
Time frame: 6 months after starting the intervention
Impact of coughing on quality of life
The Leicester Cough Questionnaire (LCQ) will be used to assess the daily cough impact
Time frame: Baseline point, 1 month and 3 months after starting the intervention
Disease-specific quality of life questionnaire
The Quality of life of Bronchiectasis (QoL-B) questionnaire will be used to evaluate the quality of life
Time frame: Baseline point, 1 month, 3 months and 6 months after starting the intervention
Disease-specific symptoms questionnaire
The Bronchiectasis Impact Measure (BIM) outcome measure will be used to analyse the symptoms
Time frame: Baseline point, 1 month, 3 months and 6 months after starting the intervention
Exercise capacity
The sit to stand test (1 minute) will be used to assess the exercise capacity
Time frame: Baseline point, 1 month, 3 months and 6 months after starting the intervention
Exercise capacity
The six minute walk distance (6MWT) will be used to assess the exercise capacity
Time frame: Baseline point
Exacerbations
The number of exacerbations, the severity of exacerbations (hospital admission) and the time to the first exacerbation will be recorded prospectively
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Time frame: From baseline point to the end of the intervention (6 months)
Biophysical properties of spontaneous sputum samples
Spontaneous sputum samples will be collected to analyse the main biophysical markers
Time frame: Baseline point, 1 month, 3 months, 6 months
Inflammation markers (airway inflammation and systemic inflammation)
Blood and salivary samples will be collected to analyse the main inflammatory markers (neutrophil elastase, cytokines, peptides)
Time frame: Baseline point, 1 month, 3 months, 6 months