Effect of PDE5 Inhibitor on Respiratory Symptoms in COPD Complicated by Pulmonary Hypertension
VA Office of Research and Development
Summary
The investigators will study whether the drug tadalafil improves shortness of breath in 126 Veterans with Chronic Obstructive Pulmonary Disease (COPD) and high blood pressure in the lungs. The investigators will also assess whether tadalafil improves quality of life, home daily physical activity, exercise endurance, the frequency of acute flares of COPD, blood pressure in the lungs, and lung function. Veterans who enroll in the trial will be allocated by chance to either active tadalafil or an inactive identical capsule (placebo). Neither the Veteran nor the investigator will know whether the Veteran is taking tadalafil or placebo. Veterans will be followed closely in clinic or by telephone at 1, 2, 3, 4, 5, and 6 months, with attention to side effects and safety. At 1,3, and 6 months the investigators will repeat the questionnaires and testing of blood pressures in the lung and lung function. The investigators anticipate that the results of this study will determine whether tadalafil improves shortness of breath when added to usual medications for COPD.
Description
Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the US and is common among Veterans. Dyspnea, a debilitating symptom of COPD, dramatically worsens health related quality of life, is associated with a reduction in daily physical activity and greater health care utilization and is more closely associated with survival than severity of airflow limitation. Thus, it is important to have effective treatments that reduce dyspnea for Veterans with COPD. Pulmonary hypertension (PH) is a common complication of COPD that is associated with severe dyspnea, more frequen…
Eligibility
- Age range
- 35–89 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Outpatients with COPD, defined as airflow limitation with post-bronchodilator obstruction on baseline visit spirometry, identified by FEV1/FVC \< 70% or \< the lower limit of normal (5th percentile of a normal population based on Global Lung Function Initiative reference equations), OR any emphysema on chest CT noted in a clinical radiology report confirmed by study investigator review. 2. Eligible subjects must have PH documented as follows: 1. Main Pulmonary Artery/Ascending Aorta (PA/A) diameter \> 0.90 on clinically available CT scans within 12 months OR 2. M…
Interventions
- DrugTadalafil
one or 2 encapsulated tablets of encapsulated tadalafil (20MG) po QD
- DrugPlacebo
one or two encapsulated tablets of placebo po QD
Locations (5)
- Rocky Mountain Regional VA Medical Center, Aurora, COAurora, Colorado
- Atlanta VA Medical and Rehab Center, Decatur, GADecatur, Georgia
- VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MABoston, Massachusetts
- Omaha VA Nebraska-Western Iowa Health Care System, Omaha, NEOmaha, Nebraska
- Providence VA Medical Center, Providence, RIProvidence, Rhode Island