The HiLOT trial
Home high-flow therapy (HFT) has been shown to reduce acute exacerbation rates and hospital admissions in patients with chronic pulmonary obstructive disease (COPD)1,2.
With the need to grow the level of evidence on the benefits of ome HFT, HiLOT aims to evaluate the effect of using home HFT with long-term oxygen therapy (LTOT) during one year in people with COPD or interstitial lung disease (ILD), vs using LTOT alone.
Study objectives
The main objective is to evaluate the impact of home HFT with LTOT on mortality and hospitalisations in patients with COPD. The trial will also evaluate the benefit(s) of home HFT with LTOT on quality of life and symptoms and assess the cost effectiveness, compliance and tolerance of the therapy.
Patient population
Main inclusion criteria
• Patients admitted to hospital with an exacerbation of COPD
• Age 40-80 years with smoking history >10 pack years
• Patient’s forced expiratory volume in 1 second (FEV1) is <80% predicted
• Patient’s FEV1/forced vital capacity (FVC) < 0.7
Study details
Study type
Prospective, multicentre, open-label, randomised, controlled trial with parallel groups.
Primary investigators
Prof Nicholas Hart
Dr Patrick Murphy
Lane Fox Clinical Respiratory Physiology, Research Centre, St Thomas Hospital
Sponsor
Guy’s and St Thomas’ Hospital NHS Foundation Trust
Study design
502 patients randomised into two groups:
• Intervention: Usual care + Home HFT
• Control: Usual care
The enrolment period will last 24 months, with a follow-up period of 12 months, for a total study duration of 36 months.
The study endpoints
Primary endpoint:
12-month all cause admission-free survival
Secondary endpoints:
• Patient reported outcome measures (CAT, PSQI, EQ-5D-5L)**
• Physiological effects of HFT
• Cost utility analysis
14 centres
Learn more: Home HFT for COPD
The expert’s
voice
Dr Salvador Díaz-Lobato, a respiratory specialist, explains why home HFT is a useful treatment for COPD.
Home high-flow therapy for COPD
Learn how HFT could be indicated for home use in COPD patients experiencing secretion management issues.
Webinars on home high-flow therapy
Experts explain the evidence for using HFT in different indications, discuss current research gaps and explore the potential benefits of this emerging therapy.
This content is intended for health professionals only
*For more information visit the investigator’s research page https://www.kcl.ac.uk/research/epic-hft
**AECOPD, acute exacerbation of chronic obstructive pulmonary disease; BMI, body mass index; CAT, computerised adaptive tests; COPD, chronic obstructive pulmonary disease; EPIC, exacerbation prevention in COPD using home high flow therapy; EQ-5D-5L, EuroQol 5-dimension, 5-level quality of life questionnaire; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; HFT, high flow therapy; NIV, non-invasive ventilation; OSA, obstructive sleep apnoea; PaCO2, partial pressure of carbon dioxide; PAP, positive airway pressure; PSQI, Pittsburgh sleep quality index.
Content last updated: 03/2024
