Ig PRx in AECOPD: Pilot Study
Chronic Obstructive Pulmonary Disease
About this trial
This is an interventional other trial for Chronic Obstructive Pulmonary Disease focused on measuring AECOPD, COPD
Eligibility Criteria
Inclusion Criteria:
- Hospitalized adult patient with AECOPD (clinically dominant AECOPD in the case of multiple co-morbidities eg. absence of overt lobar pneumonia or acute congestive heart failure or alternate diagnosis such as acute coronary syndrome or pulmonary embolism)
- Diagnosis of severe COPD (post bronchodilator FEV1 <50%, FEV1/FVC ratio <0.7) made by standard spirometry within previous 12 months or within three days of admission if previous PFT data is not available
- Age >40 years
- >10 pack year smoking history
- At least one COPD exacerbation in the previous 12 months before enrollment, defined by having had documented inpatient or outpatient treatment by physician with antibiotics and/or prednisone for physician diagnosed COPD exacerbation
- Expected to live > 12 months
Exclusion Criteria:
- Known severe hypersensitivity to immunoglobulin or its components (anaphylaxis)
- Underlying malignancy (including chronic lymphocytic leukemia)
- History of hematopoietic stem cell transplant or solid organ transplant
- Current treatment with a biological therapy for other conditions
- Concomitant significant immunodeficiency or on immunosuppressive treatment other than for COPD
- Alpha-1 antitrypsin deficiency
- Significant proteinuria (dipstick proteinuria ≥ 3+ or known urinary protein loss ≥ 2 g/day or nephrotic syndrome) and/or has acute renal failure and/or severe renal impairment (creatinine more than 2.5 times the upper limit of normal and/or on dialysis)
- IgA deficiency (IgA <0.1 g/L)
- Immunoglobulin therapy in the last 12 months or on current Ig therapy or have a clinical indication for Ig replacement therapy (www.nacblood.ca/resources/guidelines/IVIG.html)
- Obesity (BMI ≥35 kg/m²)
- Pregnancy
Sites / Locations
- The Ottawa Hospital, General Campus
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Intervention Arm 1: Treatment
Intervention Arm 2: Control
Baseline Ig < 7g/L group - Intravenous immunoglobulin (IVIG) 0.8 g/kg will be given within 12 hours after randomization during hospital admission and then every 4 weeks for 44 weeks (total 48 weeks). Baseline Ig > or = 7 g/L group - Intravenous immunoglobulin (IVIG) 0.5 g/kg will be given within 12 hours after randomization during hospital admission and then every 4 weeks for 44 weeks (total 48 weeks).
Baseline Ig < 7g/L group - Normal Saline (0.9% NaCl) 8 mL/kg will be given within 12 hours after randomization during hospital admission and then every 4 weeks for 44 weeks (total 48 weeks). Baseline Ig > or = 7 g/L group - Normal Saline (0.9% NaCl) 5 mL/kg will be given within 12 hours after randomization during hospital admission and then every 4 weeks for 44 weeks (total 48 weeks).