Inhaled Beclomethasone After Community-Acquired Respiratory Viral Infection in Lung Transplant Recipients

The Washington University

Status and phase

Completed

Phase 2

Phase 1

Conditions

Lung Transplant Infection

Treatments

Drug: Placebo

Drug: Inhaled beclomethasone

Study type

Interventional

Funder types

Other

Identifiers

NCT02351180

WUIBCARV1-201404080

Details and patient eligibility

About

The purpose of this study is to determine if the use of inhaled beclomethasone after a community-acquired respiratory viral infection in a lung transplant recipient decreases the risk of the subsequent development of chronic lung allograft dysfunction.

Full description

Community-acquired respiratory viral (CARV) infections after lung transplantation are associated with an increased risk for the development of chronic lung allograft dysfunction (CLAD) after lung transplantation. The exact mechanisms whereby CARV infections increase this risk are unknown. We propose that viral infection results in airway epithelial cell injury and the expression of injury-response genes that provide signals that initiate immunologic and non-immunologic pathways that result in the airway remodeling characteristic of obliterative bronchiolitis, the predominant pathology of CLAD. Systemic and inhaled corticosteroids are frequently used as anti-inflammatory agents to treat the peribronchiolar inflammation seen in viral bronchiolitis. Beneficial effects from corticosteroids have been reported, but this has not been demonstrated in lung transplant recipients. The aim of this single center, randomized, double blind, placebo controlled study is to evaluate the short and long term effects of a 6 month course of inhaled beclomethasone on adult lung transplant recipients with CARV infection.

Enrollment

16 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Adult (≥ 18 years old)
Single, bilateral, or heart-lung transplant recipient
Confirmed infection with a community-acquired respiratory virus including: adenovirus, coronavirus, influenza A or B, respiratory syncytial virus (RSV), parainfluenza virus (PiV), human metapneumovirus (hMPV), and rhinovirus
At least 6 months post-transplant, with completion of 6 month bronchoscopy if indicated
Able and willing to give written informed consent and comply with study procedures (e.g. testing, treatment)

Exclusion criteria

BOS Stage 3
Requirement for mechanical ventilation at study entry
Use of inhaled steroids at the time of CARV infection
Any condition that in the investigator's opinion would preclude the patient's participation in a clinical trial
Lack of available spirometric data to establish a baseline forced expiratory volume in 1 second and/or forced vital capacity
Pregnancy
Current participation in another interventional clinical trial