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Glucocorticoids Versus Placebo for the Treatment of Acute Exacerbation of Idiopathic Pulmonary Fibrosis
Sponsor: Fondation Hôpital Saint-Joseph
Summary
Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is associated with a poor prognosis, with a 3-month mortality rate of over 50%. To date, no treatment has been proven to be effective in AI-FPI. The interest of glucocorticoids is controversial and needs to be confirmed. This confirmation is mandatory to validate the improvement of the prognosis of EA-IPF under this treatment but also to search for unsuspected deleterious effects as it has been shown with immunosuppressants in stable idiopathic pulmonary fibrosis.
Official title: Glucocorticoids Versus Placebo for the Treatment of Acute Exacerbation of Idiopathic Pulmonary Fibrosis: a Randomized Controlled Trial
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
110
Start Date
2023-10-26
Completion Date
2026-12-31
Last Updated
2026-03-02
Healthy Volunteers
No
Interventions
Methylprednisone/Prednisone
Patients will be enrolled during their hospitalization in pneumology department, as part of current practice, within 7 days of the screening visit. The investigator will perform randomization by connecting to the eCRF, randomization be stratified for the severity of IPF and the treatment with antifibrotic therapy (Nintedanib or Pirfenidone) (yes/no). If patient is randomized in Glucocorticoids Group: * Day 1, 2 and 3: Intravenous Methylprednisolone 10 mg/kg/d (without exceeding 1000 mg/d). Vials of injectable solution of methylprednisolone® are diluted in 100 ml of NaCl 0.9% or G5%. Perfusion duration is between 20 to 30 minutes. * From day 4 to Day 30: Oral Prednisone slow tappering * 1 mg/kg/d for 7 days * 0.5 mg/kg/d for 7 days * 0.25 mg/kg/d for 7 days, * 10 mg/d until Day 30. For 10mg/kg, 1 mg/kg, 0.5 mg/kg, 0.25 mg/kg; rounding to 5 decimal lower if decimal ≤ 7 and the top ten if decimal ≥ 8.
Placebo
Patients will be enrolled during their hospitalization in pneumology department, as part of current practice, within 7 days of the screening visit. The investigator will perform randomization by connecting to the eCRF, randomization be stratified for the severity of IPF and the treatment with antifibrotic therapy (Nintedanib or Pirfenidone) (yes/no). If patient is randomized in Placebo Group: Day 1, 2 and 3: Intravenous Methylprednisolone-Placebo From Day 4 to Day 30: Oral Prednisone-Placebo The Methylprednisolone-Placebo corresponds to 100 ml of NaCl 0.9 % or G5%. Perfusion duration is between 20 to 30 minutes. For the Prednisone-Placebo, the placebo was an oral solution formulated with a bittering agent (pharmaceutical excipient). Specifically, in place of prednisone, sucrose octaacetate (defined as a GRAS-'Generally Recognized as Safe' excipient by the EMA) was used at 5 mg/mL.
Locations (29)
CHU ANgers
Angers, France
CHU de Besancon
Besançon, France
Hôpital Avicenne
Bobigny, France
CHU BOrdeaux
Bordeaux, France
CHU Caen
Caen, France
CHU Clermont-Ferrand
Clermont-Ferrand, France
CHIC
Créteil, France
CHU de Dijon
Dijon, France
CHU Grenoble
Grenoble, France
CHRU Lille
Lille, France
Hospices Civils de Lyon
Lyon, France
Hôpital Nord
Marseille, France
CHU de Montpellier
Montpellier, France
CHU Nancy
Nancy, France
CHU de Nantes
Nantes, France
CHU Nice
Nice, France
Hôpital Paris Saint-Joseph
Paris, France
Hôpital Bichat
Paris, France
Hôpital Européen Georges Pompidou
Paris, France
Hôpital FOCH
Paris, France
Hôpital Kremiln Bicetre
Paris, France
Hôpital Saint-Louis
Paris, France
Hôpital Tenon
Paris, France
CHU Reims
Reims, France
CHU Rennes
Rennes, France
CHU Rouen
Rouen, France
CHU Strasbourg
Strasbourg, France
CHU Toulouse
Toulouse, France
CHU Tours
Tours, France