Do Blood Tests Help to Decide Which Patients With Flares of Chronic Obstructive Pulmonary Disease (COPD) Need Antibiotics and Steroids?

Launched by OTTAWA HOSPITAL RESEARCH INSTITUTE · Apr 8, 2025

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ClinConnect Summary

This clinical trial is looking at whether two simple blood tests can help doctors decide if patients with flare-ups of chronic obstructive pulmonary disease (COPD) need antibiotics and steroids. The goal is to see if using these tests can reduce the use of these medications without affecting how well patients recover from their flare-ups. Before launching a larger study, researchers want to test their plan in a smaller group of participants to see if it works. They will check how many patients can be included, how many follow their treatment plans, and gather information on symptoms like cough or shortness of breath.

To be eligible for this study, participants must have a confirmed diagnosis of COPD and experience an increase in respiratory symptoms that requires more medication. During the study, participants will visit the clinic during a flare-up for an evaluation, which includes a chest X-ray and blood tests. They will also receive follow-up calls after 3, 14, and 30 days to check on their progress, including whether they took their medications and if they needed additional medical care. This trial is not yet recruiting but is open to all adults who meet the criteria.

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Eligibility criteria

• Inclusion Criteria:
• • Outpatients with a known diagnosis of COPD (must have prior spirometry documenting FEV1/FVC post-bronchodilator \< 0.7 or documented respirologist-diagnosis of COPD)
• • Presenting with AECOPD, defined as an increase in respiratory symptoms necessitating an increase in medications
• • Consent provided
• Exclusion Criteria:
• * An individual who meets any of the following criteria will be excluded from participation in this study:
• • new infiltrate on chest x-ray day of randomization
• • temperature ≥ 38.0 ◦C taken orally day of randomization
• • positive blood culture day of randomization
• • co-morbid asthma or severe bronchiectasis
• • acute heart failure day of randomization
• • known immunosuppression including the use of chronic glucocorticoids day of randomization
• • allergy/absolute contraindication to the use of oral steroids
• • planned pregnancy or currently pregnant
• • COVID positive