Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
MY TRIALS
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Register a trial
The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03917914
Registration number
NCT03917914
Ethics application status
Date submitted
10/04/2019
Date registered
17/04/2019
Titles & IDs
Public title
Preventing Adverse Cardiac Events in COPD
Query!
Scientific title
Preventing Adverse Cardiac Events in Chronic Obstructive Pulmonary Disease
Query!
Secondary ID [1]
0
0
PACE in COPD
Query!
Universal Trial Number (UTN)
Query!
Trial acronym
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
Chronic Obstructive Pulmonary Disease
0
0
Query!
Cardiovascular Diseases
0
0
Query!
Condition category
Condition code
Respiratory
0
0
0
0
Query!
Chronic obstructive pulmonary disease
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
Treatment: Drugs - Bisoprolol
Treatment: Drugs - Placebo Oral Tablet
Active comparator: Bisoprolol - 1.25, 2.5 or 5mg of bisoprolol daily
Placebo comparator: Placebo - 1.25, 2.5 or 5mg of matched placebo daily
Treatment: Drugs: Bisoprolol
As in arm description
Treatment: Drugs: Placebo Oral Tablet
As in arm description
Query!
Intervention code [1]
0
0
Treatment: Drugs
Query!
Comparator / control treatment
Query!
Control group
Query!
Outcomes
Primary outcome [1]
0
0
All-cause mortality
Query!
Assessment method [1]
0
0
Composite outcome of the following that will be analysed using a win-ratio apprach according to clinical importance
Query!
Timepoint [1]
0
0
Baseline to 24 months
Query!
Primary outcome [2]
0
0
Hospitalisation for COPD exacerbation
Query!
Assessment method [2]
0
0
Query!
Timepoint [2]
0
0
Baseline to 24 months
Query!
Primary outcome [3]
0
0
Hospitalisation for primary cardiac cause (ischaemia, arrhythmia, heart failure or ischaemic stroke)
Query!
Assessment method [3]
0
0
Query!
Timepoint [3]
0
0
Baseline to 24 months
Query!
Primary outcome [4]
0
0
Moderate COPD exacerbation - not hospitalised by treated with oral corticosteroids/antibiotics or both
Query!
Assessment method [4]
0
0
Query!
Timepoint [4]
0
0
Baseline to 24 months
Query!
Primary outcome [5]
0
0
Cardiac Hospitalisation for cardiac cause other than ischemia, arrythmia or heart failure
Query!
Assessment method [5]
0
0
Query!
Timepoint [5]
0
0
Baseline to 24 months
Query!
Primary outcome [6]
0
0
Respiratory hospitalisation for a respiratory cause other than COPD exacerbation
Query!
Assessment method [6]
0
0
Query!
Timepoint [6]
0
0
Baseline to 24 months
Query!
Primary outcome [7]
0
0
Decrease in FEV1 or greatest FEV1% drop - largest decrease in FEV1 from post-bronchodiliator spirometry at baseline
Query!
Assessment method [7]
0
0
Query!
Timepoint [7]
0
0
Baseline to 24 months
Query!
Primary outcome [8]
0
0
Mild COPD exacerbation - treated with increased inhalers/inhaler technique/addition of theophylline
Query!
Assessment method [8]
0
0
Query!
Timepoint [8]
0
0
Baseline to 24 months
Query!
Primary outcome [9]
0
0
Higher SGRQ score (clinically important change >= 4)
Query!
Assessment method [9]
0
0
Query!
Timepoint [9]
0
0
Baseline to 12 and 24 months
Query!
Primary outcome [10]
0
0
Higher CAT score (clinically important change >= 2)
Query!
Assessment method [10]
0
0
Query!
Timepoint [10]
0
0
Baseline to 12 and 24 months
Query!
Secondary outcome [1]
0
0
Time to first moderate-severe COPD Exacerbation
Query!
Assessment method [1]
0
0
Query!
Timepoint [1]
0
0
Baseline to 24 months
Query!
Secondary outcome [2]
0
0
Severe (hospital admission) COPD exacerbation rate (annualised)
Query!
Assessment method [2]
0
0
Query!
Timepoint [2]
0
0
Baseline to 24 months
Query!
Secondary outcome [3]
0
0
Number of events of composite (annualised) cardio-respiratory hospital admissions and MACE
Query!
Assessment method [3]
0
0
Query!
Timepoint [3]
0
0
Baseline to 24 months
Query!
Secondary outcome [4]
0
0
Quality of life assessed by St George's Respiratory Questionnaire (SGRQ)
Query!
Assessment method [4]
0
0
The SGRQ is a 50-item questionnaire developed to measure health status (quality of life) in patients with diseases of airways obstruction.
Scores are calculated for three domains:
Symptoms, Activity and Impacts (Psycho-social) as well as a total score.
Psychometric testing has demonstrated its repeatability, reliability and validity. Sensitivity has been demonstrated in clinical trials.
A minimum change in score of 4 units was established as clinically relevant after patient and clinician testing. The SGRQ has been used in a range of disease groups including asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis, and in a range of settings such as randomised controlled therapy trials and population surveys.
Query!
Timepoint [4]
0
0
Baseline to 24 months
Query!
Secondary outcome [5]
0
0
EuroQoL Group 5-5 Dimension self-report questionnaire (EQ-5D-5L) to assess health state utilities
Query!
Assessment method [5]
0
0
EQ-5D-5L consists of 2pg: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS).
Five dimensions: mobility, self-care, usual activities, pain/discomfort, anxiety/depression.
Each dimension 5 levels: no problems, slight problems, moderate problems, severe problems, extreme problems.
Patient indicates their health state by ticking most appropriate statement in each of the five dimensions.
This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.
EQ VAS records patient's self-rated health on a vertical visual analogue scale. Endpoints are labelled 'The best health you can imagine' and 'The worst health you can imagine'. The VAS can be used as a quantitative measure of health outcome that reflect the patient's own judgement.
Query!
Timepoint [5]
0
0
Baseline to 24 months
Query!
Secondary outcome [6]
0
0
Healthcare utilisation costs and Quality Adjusted Life Years (QALYs) evaluation of the treatment intervention
Query!
Assessment method [6]
0
0
Mean differences in healthcare utilisation costs and Quality Adjusted Life Years between both treatment groups will be estimated.
Costs will be ascertained from participants and study records. Health care utilisation will be on the basis of self-reported GP and hospital attendances and changes in concomitant medication. Health state utilities will be estimated via the EQ-5D-5L and will be used to weight survival up to 24 months to determine Quality Adjusted Life Years.
Query!
Timepoint [6]
0
0
Baseline to 24 months
Query!
Secondary outcome [7]
0
0
Health status assessed by COPD Assessment Test (CAT)
Query!
Assessment method [7]
0
0
Query!
Timepoint [7]
0
0
Baseline to 24 months
Query!
Secondary outcome [8]
0
0
Clinic spirometry: post-bronchodilator FEV1 (Forced Expiratory Volume) (L)
Query!
Assessment method [8]
0
0
Query!
Timepoint [8]
0
0
Baseline to 24 months
Query!
Secondary outcome [9]
0
0
Clinic spirometry: % predicted post-bronchodilator
Query!
Assessment method [9]
0
0
Query!
Timepoint [9]
0
0
Baseline to 24 months
Query!
Secondary outcome [10]
0
0
Hospital admissions for all respiratory causes
Query!
Assessment method [10]
0
0
Query!
Timepoint [10]
0
0
Baseline to 24 months
Query!
Secondary outcome [11]
0
0
Hospital admissions for all cardiac causes
Query!
Assessment method [11]
0
0
All cardiac causes includes ischaemia, arrhythmia, heart failure, acute arrhythmia, non-ST-elevation myocardial infarction, urgent revascularisation (stent/angioplasty/coronary artery bypass grafting), and MACE events (includes myocardial infarction, sudden death, cardiac death or a fatal event in system organ classes for cardiac and vascular disorders, and serious and non-serious stroke).
Query!
Timepoint [11]
0
0
Baseline to 24 months
Query!
Secondary outcome [12]
0
0
Total Number of cardiac events: MACE plus acute arrhythmia, Non-ST-elevation myocardial infarction (NSTEMI), urgent revascularisation (stent/angioplasty/Coronary artery bypass grafting [CABGs]) and clinically diagnosed heart failure episodes.
Query!
Assessment method [12]
0
0
Query!
Timepoint [12]
0
0
Baseline to 24 months
Query!
Secondary outcome [13]
0
0
Time to a composite outcome (includes any) of: all-case mortality; hospitalisation for COPD exacerbation, hospitalisation for primary cardiac cause (arrytmmia, ischaemia or heart failure) or MACE
Query!
Assessment method [13]
0
0
Query!
Timepoint [13]
0
0
Baseline to 24 months
Query!
Secondary outcome [14]
0
0
COPD exacerbation rate (annualised)
Query!
Assessment method [14]
0
0
Query!
Timepoint [14]
0
0
Baseline to 24 months
Query!
Eligibility
Key inclusion criteria
Participants will be eligible for this study if they qualify on all of the following:
1. Have provided written informed consent
2. Have COPD defined by the 2019 Global Initiative for Chronic Obstructive Lung Disease (GOLD) diagnostic criteria
3. Aged 40-85 years
4. FEV1 =30% and =70% predicted post-bronchodilator
5. FEV1/FVC <0.7 post-bronchodilator
6. Have had a COPD exacerbation in the previous 24 months requiring oral corticosteroid, antibiotics, or both
7. If taking maintenance OCS, dosage is stable and =10mg daily for 4 weeks prior to randomisation
8. Resting SBP =100mmHg
9. SBP and spirometry criteria must be met after the test dose of bisoprolol of 1.25mg
10. (New Zealand only) A history of cardiovascular disease, including heart failure, ischaemic heart disease, tachyarrhythmias, and hypertension
Query!
Minimum age
40
Years
Query!
Query!
Maximum age
85
Years
Query!
Query!
Sex
Both males and females
Query!
Can healthy volunteers participate?
No
Query!
Key exclusion criteria
Participants will be ineligible for the study if they have any of the following:
1. Concurrent therapy with any other ß-blocker
2. Resting HR <60bpm
3. Unstable left HF (i.e. symptomatic and/or necessary change in management in the last 12 weeks, or in clinicians' opinion)
4. Clinically significant pulmonary hypertension, which in the investigator's opinion would be a contraindication for ß-blocker therapy
5. Severe end-stage peripheral vascular disease
6. 2nd or 3rd degree heart block
7. Currently using or have been prescribed LTOT or resting saturated oxygen level <90% when stable
8. Expected survival is less than 12 months, or in the investigator's opinion, the person has such unstable disease (of any type) that maintaining 12 months' participation would be unlikely
9. Clinical instability since a MACE in the previous 12 weeks
10. Lower respiratory tract infection or AECOPD within the last 8 weeks
11. COPD not clinically stable as determined by the investigator
12. In the clinician's view, have asthma-COPD overlap or co-existent asthma are present; or an improvement in FEV1 =400mL post-bronchodilator is observed on two occasions
13. Females of child-bearing age and capability who are pregnant or breastfeeding or those in this group not using adequate birth control
14. Coexistent illness which precludes participation in the study (poorly controlled diabetes, active malignancy)
15. Severe end-stage liver disease defined by INR>1.3 and albumin<30g/L or portal hypertension/ascites
16. High chance in the view of the treating physician that the potential participant will not adhere to study requirements
Query!
Study design
Purpose of the study
Prevention
Query!
Allocation to intervention
Randomised controlled trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Query!
Masking / blinding
Blinded (masking used)
Query!
Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
Query!
Query!
Query!
Query!
Intervention assignment
Parallel
Query!
Other design features
Query!
Phase
Phase 3
Query!
Type of endpoint/s
Query!
Statistical methods / analysis
Query!
Recruitment
Recruitment status
Active, not recruiting
Query!
Data analysis
Query!
Reason for early stopping/withdrawal
Query!
Other reasons
Query!
Date of first participant enrolment
Anticipated
Query!
Actual
30/06/2020
Query!
Date of last participant enrolment
Anticipated
Query!
Actual
Query!
Date of last data collection
Anticipated
1/03/2025
Query!
Actual
Query!
Sample size
Target
Query!
Accrual to date
Query!
Final
280
Query!
Recruitment in Australia
Recruitment state(s)
NSW,QLD,WA
Query!
Recruitment hospital [1]
0
0
Campbelltown Hospital - Campbelltown
Query!
Recruitment hospital [2]
0
0
Liverpool Hospital - Liverpool
Query!
Recruitment hospital [3]
0
0
John Hunter Hospital & Hunter Medical Research Institute - Newcastle
Query!
Recruitment hospital [4]
0
0
Concord Repatriation General Hospital - Sydney
Query!
Recruitment hospital [5]
0
0
Westmead Hospital - Sydney
Query!
Recruitment hospital [6]
0
0
Prince Charles Hospital - Brisbane
Query!
Recruitment hospital [7]
0
0
Princess Alexandra Hospital - Brisbane
Query!
Recruitment hospital [8]
0
0
Gold Coast University Hospital - Southport
Query!
Recruitment hospital [9]
0
0
Fiona Stanley Hospital - Murdoch
Query!
Recruitment hospital [10]
0
0
TrialsWest Pty Ltd - Perth
Query!
Recruitment hospital [11]
0
0
Institute for Respiratory Health - Perth
Query!
Recruitment postcode(s) [1]
0
0
2560 - Campbelltown
Query!
Recruitment postcode(s) [2]
0
0
2170 - Liverpool
Query!
Recruitment postcode(s) [3]
0
0
2305 - Newcastle
Query!
Recruitment postcode(s) [4]
0
0
2139 - Sydney
Query!
Recruitment postcode(s) [5]
0
0
2145 - Sydney
Query!
Recruitment postcode(s) [6]
0
0
4032 - Brisbane
Query!
Recruitment postcode(s) [7]
0
0
4102 - Brisbane
Query!
Recruitment postcode(s) [8]
0
0
4215 - Southport
Query!
Recruitment postcode(s) [9]
0
0
6150 - Murdoch
Query!
Recruitment postcode(s) [10]
0
0
6000 - Perth
Query!
Recruitment postcode(s) [11]
0
0
6009 - Perth
Query!
Recruitment outside Australia
Country [1]
0
0
New Zealand
Query!
State/province [1]
0
0
Auckland
Query!
Country [2]
0
0
New Zealand
Query!
State/province [2]
0
0
Christchurch
Query!
Country [3]
0
0
New Zealand
Query!
State/province [3]
0
0
Dunedin
Query!
Country [4]
0
0
New Zealand
Query!
State/province [4]
0
0
Hamilton
Query!
Country [5]
0
0
New Zealand
Query!
State/province [5]
0
0
Wellington
Query!
Funding & Sponsors
Primary sponsor type
Other
Query!
Name
The George Institute
Query!
Address
Query!
Country
Query!
Ethics approval
Ethics application status
Query!
Summary
Brief summary
A double-blind, randomised controlled trial in participants with COPD to assess the efficacy of proactive treatment of cardiac risk in people with COPD. We hypothesise that treating known and undiagnosed CVD in COPD participants will improve both cardiac and respiratory outcomes.
Query!
Trial website
https://clinicaltrials.gov/study/NCT03917914
Query!
Trial related presentations / publications
Martin A, Hancox RJ, Chang CL, Beasley R, Wrobel J, McDonald V, Dobler CC, Yang IA, Farah CS, Cochrane B, Hillis GS, Scowcroft CP, Aggarwal A, Di Tanna GL, Balicki G, Galgey S, Jenkins C. Preventing adverse cardiac events (PACE) in chronic obstructive pulmonary disease (COPD): study protocol for a double-blind, placebo controlled, randomised controlled trial of bisoprolol in COPD. BMJ Open. 2021 Aug 27;11(8):e053446. doi: 10.1136/bmjopen-2021-053446.
Query!
Public notes
Query!
Contacts
Principal investigator
Name
0
0
Prof Christine Jenkins
Query!
Address
0
0
The George Institute
Query!
Country
0
0
Query!
Phone
0
0
Query!
Fax
0
0
Query!
Email
0
0
Query!
Contact person for public queries
Name
0
0
Query!
Address
0
0
Query!
Country
0
0
Query!
Phone
0
0
Query!
Fax
0
0
Query!
Email
0
0
Query!
Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
Query!
No/undecided IPD sharing reason/comment
Query!
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03917914