A Phase 3 interventional study of inhaled corticosteroid and long-acting beta2-agonist in Asthma and Lung Diseases, sponsored by National Heart, Lung, and Blood Institute (NHLBI). Completed. Open to participants aged Up to 18 Years. Per ClinicalTrials.gov, last updated 2016-07-12.
Sponsored by National Heart, Lung, and Blood Institute (NHLBI) · Phase 3, Interventional, and Treatment
To evaluate current and novel therapies and management strategies for children with asthma. The emphasis is on clinical trials that help identify optimal therapy for children with different asthma phenotypes, genotypes, and ethnic backgrounds and children at different developmental stages.
BACKGROUND:
Asthma is a complex disease that often starts early in life. Exacerbations can be triggered by a number of agents such as allergens, respiratory infections, environmental tobacco smoke and pollutants, drugs, chemicals, exercise, cold air, infections and strong emotion making asthma therapy difficult and sometimes complicated. Multiple medications are often required to treat symptoms (bronchodilator agents such as beta-2 adrenergic agonists, theophylline, and anticholinergics), as well the underlying disease process (anti-inflammatory agents such as inhaled and systemic corticosteroids, cromolyn sodium and nedocromil; and leukotriene modifiers).
The prevalence of asthma is increasing in all age groups, but most particularly in children under the age of 18 years. In 1992, the prevalence of self-reported asthma among persons under 18 years of age was 7.2 percent, compared to 5.1 percent among all persons. The most rapid increase in asthma has occurred in children under 5 years old, with rates increasing over 160 percent over the past 15 years. Among all ages, over 450,000 hospitalizations, 5,000 deaths, and more than 100 million days of restricted activity are due to asthma every year. Yet the burden of asthma disproportionately affects children. For example, asthma hospitalization rates are highest among persons age 0-4 years, and have increased over 28 percent in the last 15 years; mortality rates increased faster among those aged 5 to-12 years than among those age 15-34 years and neither changes in disease coding nor improved recognition of asthma fully explain these increases. Nearly one third of children restrict their activities due to asthma, including participation in physical education and sports.
Despite major advances in understanding the etiology and pathophysiology of asthma and the development of new therapeutic modalities to control symptoms and prevent exacerbations, effective therapies are not widely used in the pediatric health care community. Further, the long term effects and side effects of asthma medications in children, especially children under the age of 12 years, are not well understood. Much remains to be learned about the impact of asthma therapy at different ages and at different points in the natural history of the asthma in altering the progression, chronicity, or severity of the disease.
There is an urgent need to rapidly evaluate new and existing therapeutic approaches for children with asthma, and to disseminate the findings to health care professionals, patients and the public. There are several reasons why a pediatric asthma clinical research network will accelerate clinical research and meet this need. The highly variable and sometimes complicated clinical manifestations of asthma often make it difficult to accumulate a large number of comparable patients in one center. Further, uniformity in treatment protocols may reduce the number of patients needed at each clinical center. Also, the network mechanism will help pool the necessary clinical expertise and administrative resources to facilitate the conduct of multiple and novel therapeutic trials in a timely, efficient manner. This, in turn, would promote rapid dissemination of research findings to health care professionals.
DESIGN NARRATIVE:
Pediatric Asthma Controller Trial (PACT) is a study to determine the comparative effectiveness of inhaled corticosteroid, a leukotriene receptor antagonist, or a combination medication of inhaled corticosteroid and long-acting beta2-agonist in children with mild asthma. The study addresses a critical question facing primary care physicians about the optimal choice for initiating daily long-term treatment in children. The primary study outcome is the percentage of days without asthma during the 12-month treatment period. Recruitment began in August, 2002. A total of 300 children were assigned to one of three active treatment arms for 12 months: active ICS; a combination of active ICS and salmeterol; or active montelukast (LTRA). Major outcomes on the follow-up of 277 children were presented in May, 2005 at the American Thoracic Society meeting.
The study completion date listed in this record was obtained from the "Completed Date" entered in the Query View Report System (QVR).
4,010 studies on the registry are indexed under Asthma; 514 are open to participants now.
Browse Asthma studies →National Heart, Lung, and Blood Institute (NHLBI) is the lead sponsor of 1,143 studies on the registry; 72 are open to participants now.
Of its 58 completed or terminated interventional studies of FDA-regulated products, 50 (86%) have results posted.
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Asthmatic children from birth to 18 years. Emphasis is placed on infants and young children through 5 years of age.
No study locations are listed for this record.
The record gives a start of Aug 2002 and a completion of Sep 2004. It does not say whether these dates are actual or estimated.
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This study is completed, as verified in Jan 2006. You cannot join it, but the record below documents what was studied.
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