ON-EPIC Nitrate supplementation to enhance rehabilitation in COPD
Research type
Research Study
Full title
ON-EPIC Oral nitrate supplementation to enhance pulmonary rehabilitation in chronic obstructive pulmonary disease
IRAS ID
160729
Contact name
Nicholas Hopkinson
Contact email
Duration of Study in the UK
1 years, 11 months, 30 days
Research summary
Background: Despite optimum medical treatment many patients with chronic obstructive pulmonary disease (COPD) remain significantly disabled. Pulmonary rehabilitation, a course of supervised exercise sessions and education is an effective therapy but access is limited and it is important to ensure that the best response is achieved. There is evidence that dietary nitrate supplementation can reduce the oxygen cost of exercise and so improve exercise capacity. The purpose of this project is to investigate whether regular dietary supplementation in the form of a beetroot juice preparation can enhance the response of COPD patients to pulmonary rehabilitation.
Study Design: A multicentre, double-blind randomised placebo controlled trial in patients with COPD undergoing pulmonary rehabilitation. This will compare the effect of 140ml of nitrate-rich beetroot juice (0.8g nitrate) vs 140ml of placebo (nitrate-depleted beetroot juice) on exercise capacity measured using a walking test. 140 stable COPD patients who are limited in their day to day activities will be recruited. Secondary endpoints will be health status and the effect on patients’ nitrate levels will be assessed to see if this influences response. In a subgroup of participants we will also measure "flow-mediated dilatation" which is a measure of how reponsive blood vessels are.
Expected outcome: There is a need for novel strategies to improve exercise capacity in COPD and to improve the effectiveness of pulmonary rehabilitation. As a relatively cheap, non-drug intervention beetroot juice has the potential to be widely applicable.
REC name
London - London Bridge Research Ethics Committee
REC reference
14/LO/1474
Date of REC Opinion
1 Oct 2014
REC opinion
Further Information Favourable Opinion