Asthma Clinical Trial
Official title:
Childhood Asthma Research and Education (CARE) Network Trial - Treating Children to Prevent Exacerbations of Asthma (TREXA)
Asthma is a common, serious illness among children in the United States. It can be effectively controlled through the use of preventative medications and "rescue" medications, which are used to control symptoms. This study will evaluate the impact and severity of asthma exacerbations that occur in children with mild persistent asthma who are receiving various combinations of medications for daily and rescue use.
Almost 9 million children in the United States have asthma, and it is a leading cause of
hospitalizations and school absenteeism. Common asthma symptoms include wheezing, shortness
of breath, chest tightness, and coughing. While there is no cure for asthma, most children
who receive proper treatment are able to control symptoms and lead a normal life. Asthma is
commonly treated with two types of medications: long-term control medication, such as inhaled
corticosteroids (ICS), which is taken on a regular schedule to prevent symptoms and keep
asthma under control, and quick-relief, or "rescue" medication, such as albuterol, which is
used on an as-needed-basis with the onset of symptoms or an asthma attack. The purpose of
this study is to assess the impact and severity of asthma exacerbations that occur in
children with mild persistent asthma who are receiving ICS on a daily basis plus ICS and
albuterol as rescue medications.
This study will begin with a 4-week screening period during which participants will be
monitored while they use an inhaler with a low dose of ICS medication. Study visits will
occur at study entry and Week 4. Participants will undergo a physical examination, lung
function and airway pressure testing, and blood collection. At the Week 4 study visit,
participants will be randomly assigned to one of the following four groups for 44 weeks of
treatment:
- Group 1 will take ICS twice a day and ICS plus albuterol as rescue medication
- Group 2 will take ICS twice a day and placebo ICS plus albuterol as rescue medication
- Group 3 will take placebo ICS twice a day and ICS plus albuterol as rescue medication
- Group 4 will take placebo ICS twice a day and placebo ICS plus albuterol as rescue
medication
Each participant will receive three inhalers with their assigned medication. One inhaler will
be used twice daily throughout the study. The other two inhalers will be used consecutively
on an as-needed-basis as rescue medication. Study visits will occur at Weeks 8, 16, 24, 32,
40, and 48. A physical examination, blood collection, and lung function and airway pressure
testing will occur at selected visits. Questionnaires to assess quality of life and asthma
control will also be completed. A methacholine challenge test will be completed at some study
visits. This test artificially triggers an asthma attack to determine the severity of an
individual's asthma. Throughout the study, participants will record asthma symptoms and
rescue medication usage in a daily diary.
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