Respiratory Research

ASPECT: Aspirin after hospitalisation with Pneumonia to prevent cardiovascular Events randomised Controlled Trial Royal Liverpool site

The ASPECT trial is a research study looking at whether aspirin can lower the risk of heart attacks or strokes in people who are in hospital with pneumonia. The study needs to include 22,600 patients over four years to find out if aspirin helps.

Adults aged 50 and over who are admitted to hospital with pneumonia will be invited to take part. Those who agree will be randomly divided into two groups. Everyone will have the same chance of being placed in either group, so the groups will be similar.

One group will take low-dose aspirin once a day for three months, after starting with a slightly higher dose (two tablets daily) for the first week. The other group will not take any aspirin during the three months. Both groups will receive the usual care for pneumonia.

After three months, researchers will check how participants are doing. They won’t need to do anything extra, information will be collected from NHS health records that are already available. The study will look at whether people had a heart attack or stroke, or any serious side effects from taking aspirin.

Principle Investigator: Kim Barber,  Interim PI: Dr Ponnuswamy 

Predicted recruitment end date: 30/06/25

Exacerbation Prevention in COPD-High Flow Therapy (EPIC-HFT UK): Effect of Home High-Flow Therapy vs. Usual Care on Hospital Readmission or Death After an Acute Chronic Obstructive Pulmonary Disease (COPD) Exacerbation: a UK-Based Multicentre Randomised Clinical Trial

This research focuses on reducing hospital readmissions and deaths following severe flare ups of Chronic Obstructive Pulmonary Disease (COPD), known as acute exacerbations (AECOPD). These remain a major medical challenge with no effective solution currently available.

Existing strategies to prevent readmissions, such as adjusting medications, offering pulmonary rehabilitation, using remote monitoring, and providing discharge support, have had limited success in real world settings.

However, there is growing evidence that breathing support devices can help, and medical devices are playing an increasingly important role in improving outcomes for people with COPD.

This clinical trial offers a timely opportunity to test home high flow therapy (HFT), a treatment that could reduce hospital readmissions, ease COPD symptoms, increase physical activity, and improve quality of life after severe flare ups. If successful, this approach could lessen the impact of COPD on both patients and the NHS.

Principle Investigator: Dr Paul Albert 

Predicted recruitment end date: 2027

ARRIVAL: A Multicentre, Randomised, Open-Label, Parallel-Group, Phase IIIb Study to Assess the Potential for Tezepelumab-treated Patients with Severe Asthma to Reduce Background Therapy While Sustaining Asthma Royal Liverpool site

This study is testing whether people with severe asthma who take the drug tezepelumab can safely reduce their regular inhaler treatment without losing control of their asthma.

The aim is to lower reliance on inhalers, reduce side effects, and better understand severe asthma and related health issues. In some patients, daily inhaled steroids (ICS) can be reduced once asthma is under control.

Tezepelumab is a biologic medicine already approved for use in people aged 12 and over with severe asthma. It works by targeting the immune system.

The experimental part of this study is testing how reducing ICS affects asthma control and whether Tezepelumab can help maintain control or lead to remission (few or no symptoms).

Principle Investigator: Dr Livingston Chishimba 

Predicted recruitment end date: 31/10/25

This study is testing how well benralizumab, a treatment for severe eosinophilic asthma, works to reduce inflammation and changes in the airways. Researchers will use scans, biopsies, and lung function tests over 48 weeks to see how the drug affects the lungs.

This study is testing a new tablet, AZD5718, to see if it can help adults with moderate-to-severe asthma that isn’t well controlled. Participants will take the drug once a day for 12 weeks, and researchers will compare different doses, a placebo (dummy pill), and an existing treatment to see how well AZD5718 works and how safe it is.

This study is testing a new asthma treatment, itepekimab, to see how it affects gene activity in the lungs of former smokers with COPD. Participants will receive the drug by injection every two weeks and undergo lung and nasal tests before and after 12 weeks of treatment.

This international study is testing different doses of a new inhaled asthma treatment, AZD8630, in adults whose asthma is not well controlled. Over 12 weeks, researchers will assess how well the drug works and how safe it is, with some visits done virtually to reduce patient burden.

This study is testing a new oral drug called selnoflast to see if it’s safe and how it works in people with moderate to severe asthma already on standard treatment. Over 11 weeks, participants will take either selnoflast or a placebo, with samples collected to study how the drug affects inflammation in the lungs.

This study is testing a new inhaled asthma treatment, AZD4604, to see if it helps adults with moderate-to-severe asthma who are not well controlled on current medication. Around 320 participants worldwide will use the treatment or a placebo for 12 weeks to assess its safety and effectiveness.

Perpetual Observational Study of Acute Respiratory Infections presenting via Emergency Rooms and Other Acute Hospital Care Settings 

POS-ARI-ER is an observational study involving adults who come to hospital or urgent care with a sudden respiratory infection. The study aims to better understand these infections and also create a platform that can quickly support future clinical trials.

Principle Investigator: Dr Manish Gautan 

Predicted recruitment end date: 28/02/25

CONservative versus Standard care for primary spontaneous Pneumothorax (CONSEPT) 

Primary spontaneous pneumothorax (PSP) mainly affects young people and leads to around 3,000 hospital admissions each year in the UK. Current guidelines recommend treating PSP with short-term drainage (needle aspiration), or if that fails, inserting an intercostal chest drain (ICD), which usually requires hospital admission.

We have also shown that ambulatory treatment using a pleural vent can be effective. In addition, there is growing evidence that avoiding invasive procedures may be a safe and valid approach.

This study aims to find out whether conservative (non-invasive) care for large, symptomatic PSPs is better than current standard treatment.

Principle Investigator: Dr Patricia Yunger

Principle Investigator: Dr Victoria Randles 

Predicted recruitment end date: 26/02/27

TIPAL: The effectiveness and risks of Treating people with Idiopathic Pulmonary fibrosis with the Addition of Lansoprazole (TIPAL): a randomised placebo-controlled multi-centre clinical trial Aintree site

Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with no known cause. It leads to breathlessness and a persistent, hard-to-treat cough. Many people with IPF also have acid reflux (GORD), and there is growing evidence linking reflux to IPF progression.

This Phase III trial will test whether lansoprazole, a drug that reduces stomach acid, can help people with IPF. The study will include 298 participants diagnosed according to international criteria. They will be randomly assigned to take either lansoprazole or a placebo for 12 months.

The main outcome is the change in lung function (FVC) over 12 months. FVC will be measured weekly at home using a spirometer. Randomisation will be done centrally and will consider site, use of anti-fibrotic therapy, reflux status, and participation in a cough sub-study.

Principle Investigator: Dr Lisa Spencer 

This UK-wide study is testing whether 7 days of intravenous antibiotics is as effective as the usual 14-day course for treating serious lung infections in people with bronchiectasis. Researchers will compare how long it takes for symptoms to return in each group, aiming to find the best treatment length while reducing side effects, hospital stays, and antibiotic resistance.