Asthma Clinical Trial
Official title:
Asthma Management Project University Leiden
The long-term course of asthma shows variable outcome with regard to the incidence of
exacerbations and the decline of lung function over time. The present study aimed:
1. to investigate whether asthma management additionally guided by the degree of bronchial
hyperresponsiveness leads to a better outcome
2. to examine the predictors among clinical and inflammatory disease markers of the
long-term decline in lung function
Asthma is associated with a specific inflamma¬tory state of the airways. Assuming that the
degree of airway inflammation is a determinant for the long-term disease outcome, it follows
that, asthma therapy should be aimed at maximal reduction of airway inflammation, in
addition to reducing symptoms. However, according to current guidelines, therapy should only
be directed to the clinical severity of the disease. There is increasing evidence that
bronchial hyper¬respon¬siveness can be used as a non-invasive reflection of airway
inflamma¬tion [29]. However, it is still unknown whether bronchial responsiveness provides
relevant additional information for adjusting therapy during follow-up of patients with
asthma. Therefore, in this study we will:
1. compare the disease outcome in two parallel groups of patients with asthma, receiving
therapy aimed at either clinical severity only, or therapy aimed at both clinical
severity, and bronchial hyper¬responsiveness to methacho¬li¬ne. The outcome will be
assessed at three levels. First, the severity, second, lung function and bronchial
responsive¬ness, and third, humoral, cellular, and histological indices of airway
inflamma¬tion. To that end we will assess symptoms, lung function, bronchial
respon¬siveness, and immunological parameters in blood, every three months.
Furthermore, a bronchos¬copy with a bronchoalveolar lavage and bronchial biopsy will be
carried out to provide for material for immunologic and pathologic anatomical
examination, at the beginning and at the end of the study.
2. analyse the predictors among clinical- and inflammatory parameters of exacerbations and
long-term decline in lung function during long-term follow-up
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind, Primary Purpose: Treatment
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