The Chorus Trial
The Chorus Trial
Fibrotic hypersensitivity pneumonitis (FHP) is a devastating lung disease which results in scarring of the lungs. As the scarring worsens, patients struggle to breathe. They can develop a harsh, hacking cough, lose a lot of weight, have a deteriorating quality of life and may become housebound. Life expectancy after diagnosis is only 5 years on average. FHP is estimated to affect 3 people per 100,000 but is more common in those over 65 years. There are 2000 new cases per year in the UK. FHP is a condition involving thickening (inflammation) and scarring (fibrosis) and this combination makes it more complicated to treat. Treatments and care for people with FHP vary widely across the UK and there are currently no guidelines for treating FHP, so it is a priority area for research. Most people who are diagnosed with FHP are prescribed a course of corticosteroids (‘steroids’). However, there is no good evidence to say that treating FHP with steroids is the best thing to do. We also do not know whether the benefits of prescribing steroids outweigh the potential side effects. We are undertaking a randomised controlled trial (the gold standard of healthcare research) to find out if a commonly prescribed steroid called prednisolone:
To determine whether steroids are beneficial for people with FHP, we will recruit 222 recently diagnosed FHP patients from up to 30 hospitals in England, Scotland and Wales. Participants will be allocated at random (like tossing a coin) to receive either oral steroid tablets or placebo tablets (which look identical to the steroids). They will take the steroids or placebo for 6 months. We will prescribe the steroid doses that doctors regularly use and all participants will continue with any treatments they ae taking for other reasons (such as blood pressure medication). The potential benefit of the steroids will be measured using the lung function tests at the start, and after 3 and 6 months of treatment. We will ask participants to fill out questionnaires about their symptoms: breathlessness, cough, and quality of life. We will monitor for any side effects of the steroids and we will also investigate whether steroids offer value for money to the NHS and wider care services.