Clinical trials will improve treatment and follow-up

October 22, 2013 by Elin Fugelsnes & Else Lie
Clinical trials will improve treatment and follow-up
Exercise training and pulmonary rehabilitation are recommended for COPD patients at all stages of the disease, says Paolo Zanaboni. Credit: NST

Three major clinical trials will help to develop and target treatment and follow-up of patients suffering from COPD, lung cancer and rheumatoid arthritis in Norway.

"Randomised are the best method of obtaining required documentation of the effect, safety and cost-efficacy of various methods or types of treatment employed by the health services," says Kåre Birger Haugen, chair of the programme board of the Research Council of Norway's Programme on Clinical Research (KLINISKFORSKNING), which has provided funding to the studies.

Will follow up COPD patients at home

At the Norwegian Centre for Integrated Care and Telemedicine in Tromsø in Northern Norway, researchers will be studying the effect of telemedicine on people suffering from chronic obstructive pulmonary disease (COPD). Telemedicine involves treatment and monitoring activities for independent of the location of the medical expertise.

"Exercise training and pulmonary rehabilitation are recommended for COPD patients at all stages of the disease. Since we can't offer all patients pulmonary rehabilitation in an institution, we are working to develop a low-intensity telerehabilitation service for patients in their own homes," explains project manager Paolo Zanaboni.

Roughly 120 patients in Norway, Denmark and Australia will be divided into one intervention group and two control groups.

The patients in the intervention group will be given a treadmill and a device that measures their oxygen saturation and pulse rate. They will receive regular follow-up from a physiotherapist via a videoconferencing system on an iPad. The physiotherapist can adjust the exercise training programme based on measurements patients enter on a website after each training session.

The patients in one of the control groups will receive standard COPD treatment, while the patients in the other control group will be given equipment for at-home with no telemedical follow-up.

"It's important to find out whether it is the exercise on its own or the exercise in conjunction with telemedicine that is most effective," says Dr Zanaboni.

Longer life for lung cancer patients?

A new cancer study will explore whether a new therapy principle can extend the lives of patients with lung cancer with metastasis. Lung cancer is the second-most common form of cancer for both men and women in Norway, and the one with the highest mortality rate.

Some 85 per cent of the 3 000 individuals diagnosed with lung cancer each year have non-small-cell . Patients with advanced metastasised cancer have a survival rate of between seven and 14 months. Normal treatment today consists of four courses of chemotherapy. Patients may be given more chemotherapy when the cancer gets worse.

"Instead of watching and waiting after the four standard courses of chemotherapy, we will be studying the effect of immediate pemetrexed maintenance therapy. Earlier studies have shown that this can prolong survival by three to five months, or 40–50 per cent," says project manager Bjørn Grønberg, who is a consultant in oncology at the Cancer Clinic at St. Olavs Hospital in Trondheim.

"No other studies on this patient group have even hinted at a similar improvement in survival rate," Dr Grønberg points out.

Approximately 25 Norwegian hospitals will be participating in the clinical trial, which will involve 700 patients over a two-and-a-half-year period.

Can rheumatoid arthritis patients stay healthy without biologics?

"In the past 10–15 years, new biologic drugs for rheumatoid arthritis have emerged that have shown excellent results when used with modern treatment strategies. Nine of 10 patients with recently diagnosed rheumatoid arthritis treated according to these principles will cease to exhibit signs or symptoms of active disease", explains project manager Espen A. Haavardsholm at Diakonhjemmet Hospital in Oslo.

The downside is that biologics are costly, and suppress the immune system to an extent that increases the risk of infection. Now the researchers are looking to see if it is possible to discontinue the drugs and still keep patients symptom-free.

One group of patients will gradually taper off and withdraw from biologics, continuing standard treatment with older types of drugs. Another group will continue taking biologics.

"Perhaps the study will reveal that some patients should continue taking biologics, while others should stop. We will be looking for predictors that can indicate this at an early stage," says Dr Haavardsholm.

The clinical trial will involve 320 patients throughout Norway.

Explore further: Chemotherapy drug improves survival following surgery for pancreatic cancer

Related Stories

Chemotherapy drug improves survival following surgery for pancreatic cancer

October 8, 2013
Among patients with pancreatic cancer who had surgery for removal of the cancer, treatment with the drug gemcitabine for 6 months resulted in increased overall survival as well as disease-free survival, compared with observation ...

Chemo, radiation followed by surgery improves survival in lung cancer patients

April 30, 2013
In one of the largest observational studies of its kind, researchers report that a combination of chemotherapy and radiation followed by surgery in patients with stage 3 non-small cell lung cancer improves survival.

Chemotherapy helps elderly patients with small cell lung cancer

September 4, 2013
Although numerous randomized clinical trials have demonstrated a benefit of chemotherapy for patients with small-cell lung cancer (SCLC), these trials have predominantly compared different chemotherapy regimens rather than ...

Study shows COPD is not independent risk factor for lung cancer

December 15, 2012
Chronic obstructive pulmonary disease (COPD) and lung cancer are two of the most important smoking-related diseases worldwide, with a huge combined mortality bur¬den. Many consider the presence of COPD itself to be an independent ...

Expensive or not, rheumatoid arthritis drugs have similar effect: study

July 1, 2013
(HealthDay)—Treatment with a pricey biological drug was no better than cheaper, conventional therapy in terms of reducing time off from work for people with rheumatoid arthritis, a new study finds.

Targeted radiation therapy safe, effective treatment for elderly with pancreatic cancer

September 24, 2013
A highly targeted cancer radiation therapy may offer a safe and effective treatment option for elderly pancreatic cancer patients unable to undergo surgery or combined chemotherapy and radiation therapy, according to researchers ...

Recommended for you

A large-scale 'germ trap' solution for hospitals

July 26, 2017
When an infectious airborne illness strikes, some hospitals use negative pressure rooms to isolate and treat patients. These rooms use ventilation controls to keep germ-filled air contained rather than letting it circulate ...

Male hepatitis B patients suffer worse liver ailments, regardless of lifestyle

July 25, 2017
Why men with hepatitis B remain more than twice as likely to develop severe liver disease than women remains a mystery, even after a study led by a recent Drexel University graduate took lifestyle choices and environments ...

Mind-body therapies immediately reduce unmanageable pain in hospital patients

July 25, 2017
Mindfulness training and hypnotic suggestion significantly reduced acute pain experienced by hospital patients, according to a new study published in the Journal of General Internal Medicine.

Researchers report new system to study chronic hepatitis B

July 25, 2017
Scientists from Princeton University's Department of Molecular Biology have successfully tested a cell-culture system that will allow researchers to perform laboratory-based studies of long-term hepatitis B virus (HBV) infections. ...

Research examines lung cell turnover as risk factor and target for treatment of influenza pneumonia

July 24, 2017
Influenza is a recurring global health threat that, according to the World Health Organization, is responsible for as many as 500,000 deaths every year, most due to influenza pneumonia, or viral pneumonia. Infection with ...

Scientists propose novel therapy to lessen risk of obesity-linked disease

July 24, 2017
With obesity related illnesses a global pandemic, researchers propose in the Journal of Clinical Investigation using a blood thinner to target molecular drivers of chronic metabolic inflammation in people eating high-fat ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.