Inhaled Beclomethasone After Community-Acquired Respiratory Viral Infection in Lung Transplant Recipients
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Infectious Disease, Infectious Disease |
| Therapuetic Areas: | Immunology / Infectious Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/22/2019 |
| Start Date: | February 1, 2017 |
| End Date: | April 30, 2020 |
A Randomized Placebo Controlled Trial of Inhaled Beclomethasone After Community-acquired Respiratory Viral Infection in Lung Transplant Recipients
The purpose of this study is to determine if the use of inhaled beclomethasone after a
community-acquired respiratory viral infection in a lung transplant recipient decreases the
risk of the subsequent development of chronic lung allograft dysfunction.
community-acquired respiratory viral infection in a lung transplant recipient decreases the
risk of the subsequent development of chronic lung allograft dysfunction.
Community-acquired respiratory viral (CARV) infections after lung transplantation are
associated with an increased risk for the development of chronic lung allograft dysfunction
(CLAD) after lung transplantation. The exact mechanisms whereby CARV infections increase this
risk are unknown. We propose that viral infection results in airway epithelial cell injury
and the expression of injury-response genes that provide signals that initiate immunologic
and non-immunologic pathways that result in the airway remodeling characteristic of
obliterative bronchiolitis, the predominant pathology of CLAD. Systemic and inhaled
corticosteroids are frequently used as anti-inflammatory agents to treat the peribronchiolar
inflammation seen in viral bronchiolitis. Beneficial effects from corticosteroids have been
reported, but this has not been demonstrated in lung transplant recipients. The aim of this
single center, randomized, double blind, placebo controlled study is to evaluate the short
and long term effects of a 6 month course of inhaled beclomethasone on adult lung transplant
recipients with CARV infection.
associated with an increased risk for the development of chronic lung allograft dysfunction
(CLAD) after lung transplantation. The exact mechanisms whereby CARV infections increase this
risk are unknown. We propose that viral infection results in airway epithelial cell injury
and the expression of injury-response genes that provide signals that initiate immunologic
and non-immunologic pathways that result in the airway remodeling characteristic of
obliterative bronchiolitis, the predominant pathology of CLAD. Systemic and inhaled
corticosteroids are frequently used as anti-inflammatory agents to treat the peribronchiolar
inflammation seen in viral bronchiolitis. Beneficial effects from corticosteroids have been
reported, but this has not been demonstrated in lung transplant recipients. The aim of this
single center, randomized, double blind, placebo controlled study is to evaluate the short
and long term effects of a 6 month course of inhaled beclomethasone on adult lung transplant
recipients with CARV infection.
Inclusion Criteria:
- Adult (≥ 18 years old)
- Single, bilateral, or heart-lung transplant recipient
- Confirmed infection with a community-acquired respiratory virus including: adenovirus,
coronavirus, influenza A or B, respiratory syncytial virus (RSV), parainfluenza virus
(PiV), human metapneumovirus (hMPV), and rhinovirus
- At least 6 months post-transplant, with completion of 6 month bronchoscopy if
indicated
- Able and willing to give written informed consent and comply with study procedures
(e.g. testing, treatment)
Exclusion Criteria:
- BOS Stage 3
- Requirement for mechanical ventilation at study entry
- Use of inhaled steroids at the time of CARV infection
- Any condition that in the investigator's opinion would preclude the patient's
participation in a clinical trial
- Lack of available spirometric data to establish a baseline forced expiratory volume in
1 second and/or forced vital capacity
- Pregnancy
- Current participation in another interventional clinical trial
We found this trial at
1
site
660 S Euclid Ave
Saint Louis, Missouri 63110
Saint Louis, Missouri 63110
(314) 362-5000
Washington University School of Medicine Washington University Physicians is the clinical practice of the School...
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