Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Timing of Hypertonic Saline Inhalation Relative to Airways Clearance in Cystic Fibrosis
Brief Summary: Lung disease is the predominant cause of morbidity and mortality in Cystic Fibrosis (CF) with 80% of deaths resulting directly or indirectly from pulmonary disease. Abnormal airway clearance causes retention of mucus resulting in frequent chest infections. Physiotherapists use different techniques to help clear mucus from the lungs of patients with CF. Inhaled medications and airways clearance techniques (ACTs) are central to a CF patient's daily treatment and are often coordinated.

Burden of treatment is a common reason for non-adherence in this patient group, and streamlining of treatment timings is sought to optimize adherence whilst ensuring efficacy to an often complex daily regimen of inhaled bronchodilators, nebulizers and ACTs. A gap in the research exists as to the optimal timing of Hypertonic Saline (HTS) and ACT within the daily regimen. A study to show whether the timing of HTS around ACT is significant, can better inform patients and potentially allow more flexibility around their treatment regimen.

Lung Clearance Index (LCI) has shown good sensitivity to abnormalities in lung function compared with spirometry and has demonstrated a treatment effect in other trials. LCI may be a suitable tool therefore, to assess intervention strategies aimed at airways clearance in CF. This study aims to compare the effects ACTs after HTS inhalation versus ACTs during HTS inhalation as measured by LCI.

It is a randomized, crossover trial of ACTs after HTS inhalation compared with ACTs during HTS inhalation in adult CF patients during day 10-14 of a hospital admission for treatment of a pulmonary exacerbation. Patients will be randomized to receive 1 of the treatment session options on the first day and the reverse on the second day.

The primary objective of this study is to compare the change in LCI (a measure of lung function) at 90 minutes post treatment with ACTs after HTS inhalation compared with ACTs during HTS inhalation in adult CF patients.

LCI (lung clearance index) ACT (airway clearance technique) HTS (hypertonic saline)


Options:
A: Arm Label: 1; Type: EXPERIMENTAL; Interventions: Drug: mannitol | Arm Label: 2; Type: ACTIVE_COMPARATOR; Interventions: Drug: Dornase alpha | Arm Label: 3; Type: OTHER; Interventions: Drug: mannitol + pulmozyme | Intervention Type: DRUG; Name: mannitol; Assigned to Arm(s): 1 | Intervention Type: DRUG; Name: mannitol + pulmozyme; Assigned to Arm(s): 3 | Intervention Type: DRUG; Name: Dornase alpha; Assigned to Arm(s): 2
B: Arm Label: Active Treatment Group; Type: EXPERIMENTAL; Interventions: Drug: 7% Hypertonic Saline (HS) | Arm Label: Control Group; Type: ACTIVE_COMPARATOR; Interventions: Drug: 0.9% Isotonic Saline (IS) | Intervention Type: DRUG; Name: 7% Hypertonic Saline (HS); Assigned to Arm(s): Active Treatment Group | Intervention Type: DRUG; Name: 0.9% Isotonic Saline (IS); Assigned to Arm(s): Control Group
C: Arm Label: ACTs after HTS inhalation:; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Airways clearance and Hypertonic saline inhalation | Arm Label: ACTs during HTS inhalation; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Airways clearance and Hypertonic saline inhalation | Intervention Type: PROCEDURE; Name: Airways clearance and Hypertonic saline inhalation; Assigned to Arm(s): ACTs after HTS inhalation:, ACTs during HTS inhalation
D: Arm Label: Active Treatment Group; Type: EXPERIMENTAL; Interventions: Drug: Active Treatment Group 7% Hypertonic Saline | Arm Label: Control Group; Type: ACTIVE_COMPARATOR; Interventions: Drug: Control Group 0.9% Isotonic Saline | Intervention Type: DRUG; Name: Active Treatment Group 7% Hypertonic Saline; Assigned to Arm(s): Active Treatment Group | Intervention Type: DRUG; Name: Control Group 0.9% Isotonic Saline; Assigned to Arm(s): Control Group

Answer: C