Asthma Clinical Trial
Official title:
Early Anti-inflammatory Treatment of Asymptomatic or Mildly Symptomatic Airway Hyperresponsiveness
- The inflammatory process that leads to the development of asthma may be present before
the onset of asthma symptoms and cause a certain degree of airway hyperresponsiveness.
Without treatment it may induce irreversible airway structural changes that are
associated with permanent changes in airway functions, persistent airway
hyperresponsiveness and lead to the development of asthma symptoms.
- Atopic subjects with asymptomatic airway hyperresponsiveness and first degree relatives
with a history of asthma are at higher risk to develop symptomatic asthma. Early
treatment of airway inflammation in these predisposed subjects with " borderline " or
mild airway hyper-responsiveness could prevent the development of asthma symptoms, and
reduce or even normalize airway responsiveness.
- In very mild asthmatic subjects (bronchodilator need < thrice a week), early
anti-inflammatory treatment can lead to " normalisation " or airway responsiveness in a
significant number of subjects and prevent the need for subsequent regular therapy.
This is particularly true for those showing blood/sputum eosinophilia.
Objectives: To compare perception of bronchoconstriction, pulmonary function and airway
inflammation in subjects with mild symptomatic asthma and asymptomatic asymptomatic airway
hyperresponsiveness
Methods: To compare the influence of inhaled fluticasone propionate 250 mcg/day for 3 months
followed by 100 mcg/day for 9 months on airway inflammation and methacholine responsiveness
in a double-blind, placebo-controlled, parallel groups study including non-smoking atopic
subjects with mild asthma and asymptomatic airway hyperresponsiveness
- Evaluate the change in airway hyperresponsiveness and in inflammatory markers in the
blood and sputum in the population studied following a 3-month course of fluticasone
250 µg per day followed by a 9-month course of fluticasone 1000 µg per day (before
supper) compared to placebo as measured on a regular basis over a two year period.
- This study will include:
1. A baseline evaluation period of 2 weeks before starting the 3-month treatment
period followed by the 9-month treatment period.
2. Treatment will be double-blinded, randomized, parallel design.
3. A follow-up period of one year.
Optional: Bronchoscopies with bronchial biopsy sampling will be performed before and after
tratment in a subgroup of subjects to determine what is the influence of this corticosteroid
treatment on airway inflammation and remodelling.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver), Primary Purpose: Prevention
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