Asthma Clinical Trial
— DIVAOfficial title:
Vitamin D In the Prevention of Viral-induced Asthma in Preschoolers: a Randomized Controlled Multicenter Trial (DIVA)
In this 7-month randomized controlled trial, children aged 1 to less than 6 years, with recurrent asthma attacks triggered mostly by colds, will receive a high dose of vitamin D or a placebo every 3.5 months during their usual clinic visit, and a daily supplement of vitamin D or a placebo. This study will test whether children in vitamin D group have less frequent and less severe asthma exacerbations compared with those receiving placebo.The study will also document the safety profile of this strategy.
Status | Recruiting |
Enrollment | 865 |
Est. completion date | December 2025 |
Est. primary completion date | July 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 1 Year to 5 Years |
Eligibility | Inclusion Criteria: - Age 1-5 years - Physician-diagnosed asthma (as per the 2015 Canadian Position Paper on the diagnosis of preschool asthma) - =1 asthma exacerbation requiring rescue oral corticosteroids (OCS) in the past 6 months or =2 in the past 12 months (as documented by pharmacy/medical records) - =4 upper respiratory tract infections (URTIs) in the past 12 months (as per parental report) - URTIs as the main asthma trigger (as per parental report) Exclusion Criteria: - Intake > 400 IU/day of vitamin D3 supplements or fish oil in the past 3 months - Intention to use > 400 IU/day of vitamin D3 supplements or fish oil in the fall and winter - Extreme prematurity (< 28 week gestation) - No vitamin D supplementation (if breast-fed in the last 6 months) - Vitamin D restrictive diets, that is, minimal intake of vitamin D fortified milk (<250 mL/day for 1-3 years or <375 mL/day for 4-6 years AND no other (or <200 IU/day) vitamin D supplement - Recent immigrants from regions at high risk of rickets (in the past 12 months) - Recent refugees (in the past 12 months) - Undernourished children - Other chronic respiratory disease (e.g. Cystic fibrosis, Bronchopulmonary dysplasia) or chronic kidney, gastrointestinal, endocrinological or cardiac diseases, or sickle cell anemia? - History of bone disorder disease (e.g. rickets, osteomalacia) - Intake of oral anti-epileptic, diuretic or anti-fungal medications - Anticipated difficulty with follow-up or with adherence to the intervention or the procedures |
Country | Name | City | State |
---|---|---|---|
Canada | Children's Hospital of London Health Sciences Centre | London | Ontario |
Canada | CHU Sainte Justine | Montreal | Quebec |
Canada | Maisonneuve-Rosemont Hospital | Montreal | Quebec |
Canada | Montreal Children's Hospital | Montreal | Quebec |
Canada | Children's Hospital of Eastern Ontario | Ottawa | Ontario |
Canada | CHU de Québec-Université Laval | Québec | Quebec |
Canada | CHU de Sherbrooke | Sherbrooke | Quebec |
Canada | The Hospital for Sick Children | Toronto | Ontario |
Canada | British Columbia Children's Hospital | Vancouver | British Columbia |
Lead Sponsor | Collaborator |
---|---|
Professor Francine Ducharme | Canadian Institutes of Health Research (CIHR), EURO-PHARM International Canada, Inc. |
Canada,
Jensen ME, Ducharme FM, Alos N, Mailhot G, Masse B, White JH, Sadatsafavi M, Khamessan A, Tse SM, Alizadehfar R, Bock DE, Daigneault P, Lemire C, Yang C, Radhakrishnan D. Vitamin D in the prevention of exacerbations of asthma in preschoolers (DIVA): protocol for a multicentre randomised placebo-controlled triple-blind trial. BMJ Open. 2019 Dec 30;9(12):e033075. doi: 10.1136/bmjopen-2019-033075. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Hypercalciuria | Group difference in the proportion of children with =1 occurrence of hypercalciuria (urinary calcium: creatinine ratio >1.38 mmol/mmol for children aged 1-<2 years, or >1.1 mmol/mmol for children aged 2-<5 years, or >0.77 mmol/mmol for children aged =5 years) | 7 months | |
Other | Hypercalcemia | Group difference in the proportion of children with clinically significant hypercalcemia (>2.63 mmol/L) | 7 months | |
Other | Elevated serum 25-hydroxyvitamin D | Group difference in the proportion of children with =1 occurrence of elevated serum 25OHD (greater than 250 nmol/L) | 7 months | |
Other | Adverse Health Events | Group difference in the distribution of adverse health events | 7 months | |
Other | Gene expression | Group difference in the change in gene expression levels (between baseline and 3.5 months) in blood peripherical mononuclear cells, adjusted for cell distribution estimated from lymphocyte differentiation in a subset of patients | 3.5 months | |
Primary | Number of asthma exacerbations per child treated with rescue oral corticosteroids | Group difference in the mean number of exacerbations treated with rescue oral corticosteroids/child | 7 months | |
Secondary | Laboratory-confirmed respiratory infections | Group difference in mean number of laboratory-confirmed respiratory infections during asthma exacerbations | 7 months | |
Secondary | Severity of asthma symptoms during asthma exacerbations | Group difference in the mean severity of asthma symptoms documented on the 'Asthma Flare-up Diary for Young Children' | 7 months | |
Secondary | Duration of asthma symptoms during asthma exacerbations | Group difference in the mean duration of asthma symptoms documented on the validated 'Asthma Flare-up Diary for Young Children' | 7 months | |
Secondary | Intensity of use of rescue ß2-agonists during asthma exacerbations | Group difference in the mean cumulative use of rescue ß2-agonists during exacerbations documented on the validated 'Asthma Flare-up Diary for Young Children' | 7 months | |
Secondary | Parents' functional status during asthma exacerbations | Group difference in the mean parents' functional status during exacerbation as documented on the validated 'Effect of a child's asthma flare-up on parents questionnaire' | 7 months | |
Secondary | Mean number of ED visits for asthma exacerbations | Group difference in mean number of ED visits for asthma exacerbations | 7 months | |
Secondary | De-intensification of preventive asthma therapy | Group difference in proportion of children with de-intensification of preventive asthma therapy | 7 months | |
Secondary | Intervention cost-effectiveness | Cost of intervention vs. cost (family expenses and health care) of exacerbations | 7 months |
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