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Greulich T, Hohlfeld JM, Neuser P, Lueer K, Klemmer A, Schade-Brittinger C, Harnisch S, Garn H, Renz H, Homburg U, Renz J, Kirsten A, Pedersen F, Müller M, Vogelmeier CF, Watz H. A GATA3-specific DNAzyme attenuates sputum eosinophilia in eosinophilic COPD patients: a feasibility randomized clinical trial. Respir Res 2018; 19:55. [PMID: 29615049 PMCID: PMC5883532 DOI: 10.1186/s12931-018-0751-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/15/2018] [Indexed: 01/27/2023] Open
Abstract
Background A subset of COPD-patients presents with eosinophilic airway inflammation. While treatment of asthmatic patients with the GATA3-specific DNAzyme SB010 attenuated sputum eosinophilia after allergen challenge, this specific treatment has not been evaluated in patients with COPD. Our objective was to evaluate the feasibility and safety of inhaled SB010 in COPD patients with sputum eosinophilia. Methods We conducted a randomized, double-blind, placebo-controlled, multicentre clinical trial in COPD-patients with sputum eosinophilia (≥2.5% non-squamous cells). Patients inhaled 10 mg SB010 bid or matching placebo via the controlled inhalation system AKITA2 APIXNEB for 28 days. Endpoints included the feasibility of the study (primary), patient’s safety, sputum eosinophils, FENO, lung function, symptoms, and biomarkers. The study was registered in the German Clinical Trials Register: DRKS00006087. Results One hundred thirty patients were screened, 23 patients were randomized (FEV1 49.4 ± 11.5%; sputum eosinophils 8.0 ± 8.4%) and 19 patients completed the study (10 placebo, 9 SB010. After 28 days, SB010 decreased the relative sputum eosinophil count (p = 0.004) as compared to no changes in placebo-treated patients. FENO, lung function, and symptoms were not affected significantly. We found an increase in blood IFN-γ (p = 0.02) and a trend to lower IL-5 levels in patients treated with SB010. SB010 was safe and well tolerated. Thirty five AEs (22 SB010, 13 placebo including 1 SAE) were observed with 3 AEs in each group judged to be possibly treatment-related. Conclusion In patients with eosinophilic COPD, sputum eosinophils could be reduced by inhalation of SB010. Long-term studies are needed to demonstrate clinical efficacy. Electronic supplementary material The online version of this article (10.1186/s12931-018-0751-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Timm Greulich
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Centre Giessen and Marburg, Philipps-University, Member of the German Centre for Lung Research (DZL), Marburg, Germany.
| | - Jens M Hohlfeld
- Department of Respiratory Medicine, Hannover Medical School, Fraunhofer Institute for Toxicology and Experimental Medicine, Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Petra Neuser
- Coordinating Center for Clinical Trials, Member of the German Centre for Lung Research (DZL), Philipps-University, Marburg, Germany
| | - Katrin Lueer
- Department of Respiratory Medicine, Hannover Medical School, Fraunhofer Institute for Toxicology and Experimental Medicine, Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Andreas Klemmer
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Centre Giessen and Marburg, Philipps-University, Member of the German Centre for Lung Research (DZL), Marburg, Germany
| | - Carmen Schade-Brittinger
- Coordinating Center for Clinical Trials, Member of the German Centre for Lung Research (DZL), Philipps-University, Marburg, Germany
| | - Susanne Harnisch
- Coordinating Center for Clinical Trials, Member of the German Centre for Lung Research (DZL), Philipps-University, Marburg, Germany
| | - Holger Garn
- Department of Medicine, Institute of Laboratory Medicine and Pathobiochemistry - Molecular Diagnostics, Member of the German Centre for Lung Research (DZL), Philipps-University, Marburg, Germany
| | - Harald Renz
- Department of Medicine, Institute of Laboratory Medicine and Pathobiochemistry - Molecular Diagnostics, Member of the German Centre for Lung Research (DZL), Philipps-University, Marburg, Germany
| | | | - Jonas Renz
- Sterna Biologicals GmbH & Co. KG, Marburg, Germany
| | - Anne Kirsten
- Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Centre for Lung Research (DZL), Grosshansdorf, Germany
| | - Frauke Pedersen
- Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Centre for Lung Research (DZL), Grosshansdorf, Germany
| | - Meike Müller
- Department of Respiratory Medicine, Hannover Medical School, Fraunhofer Institute for Toxicology and Experimental Medicine, Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Claus F Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Centre Giessen and Marburg, Philipps-University, Member of the German Centre for Lung Research (DZL), Marburg, Germany
| | - Henrik Watz
- Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Centre for Lung Research (DZL), Grosshansdorf, Germany
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Greulich T, Nell C, Koepke J, Fechtel J, Franke M, Schmeck B, Haid D, Apelt S, Filipovic S, Kenn K, Janciauskiene S, Vogelmeier C, Koczulla AR. Benefits of whole body vibration training in patients hospitalised for COPD exacerbations - a randomized clinical trial. BMC Pulm Med 2014; 14:60. [PMID: 24725369 PMCID: PMC4021435 DOI: 10.1186/1471-2466-14-60] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 03/27/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with stable COPD show improvements in exercise capacity and muscular function after the application of whole body vibration. We aimed to evaluate whether this modality added to conventional physiotherapy in exacerbated hospitalised COPD patients would be safe and would improve exercise capacity and quality of life. METHODS 49 hospitalised exacerbated COPD patients were randomized (1:1) to undergo physiotherapy alone or physiotherapy with the addition of whole body vibration. The primary endpoint was the between-group difference of the 6-minute walking test (day of discharge - day of admission). Secondary assessments included chair rising test, quality of life, and serum marker analysis. RESULTS Whole body vibration did not cause procedure-related adverse events. Compared to physiotherapy alone, it led to significantly stronger improvements in 6-minute walking test (95.55 ± 76.29 m vs. 6.13 ± 81.65 m; p = 0.007) and St. Georges Respiratory Questionnaire (-6.43 ± 14.25 vs. 5.59 ± 19.15, p = 0.049). Whole body vibration increased the expression of the transcription factor peroxisome proliferator receptor gamma coactivator-1-α and serum levels of irisin, while it decreased serum interleukin-8. CONCLUSION Whole body vibration during hospitalised exacerbations did not cause procedure-related adverse events and induced clinically significant benefits regarding exercise capacity and health-related quality of life that were associated with increased serum levels of irisin, a marker of muscle activity. TRIAL REGISTRATION German Clinical Trials Register DRKS00005979. Registered 17 March 2014.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Andreas Rembert Koczulla
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University, Member of the German Center for Lung Research (DZL), Marburg 35043, Germany.
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