Although there have been advances in understanding the pathobiology of asthma, the average patient with asthma continues to suffer substantial morbidity. This is somewhat paradoxical since it has been established over and over again that if an asthma sufferer obtains high quality asthma care, the impact of the disease on their life can be minimized. To address this issue an expert panel was convened and practice guidelines for asthma were formulated and promulgated. During this process it became clear that there were many issues related to asthma care for which the data base to make firm and scientifically sound recommendations was minimal. Since the prevalence of asthma is so great and asthma care so costly, it is important and economically sensible to obtain the data needed to make recommendations for treatment that have stood the test of rigorous clinical investigation. Because rigorous clinical investigation is time-consuming and resource intensive it is critical to pose questions in clinical trails that have a substantial likelihood of yielding clearly defined treatment guidelines. Furthermore, such trials should use novel agents in creative protocols that will compare and contrast new and established treatments. In the proposal which follows we present two proposed clinical trials that have the potential to substantively influence asthma care and care costs. In specific the two trials proposed for consideration for performance by the network are: EMERGENCY TREATMENT OF ASTHMA: ADDITION OF A 5-LIPOXYGENASE INHIBITOR A double-blind, placebo controlled trial design will be used to determine if there is an effect of adding 2 weeks of treatment with a 5- lipoxygenase inhibitor to the standard treatment of acute asthma episodes. Lung function 90-120 minutes after starting treatment and need for hospitalization rather than discharge from the emergency service will be the primary endpoints. COMPARISON OF REGULAR VERSUS INTERMITTENT USE OF BETA AGONISTS IN PATIENTS REQUIRING INHALED STEROIDS The safety and efficacy, as reflected in overall asthma control, of recurrent plus """"""""as needed"""""""" beta agonist use will be compared to the use of beta agonists only on an """"""""as needed"""""""" basis in moderately severe asthma patients. A double-blind, placebo controlled trial design will be used in this 12 month treatment trial in patients who require continuous treatment with inhaled steroids for asthma control.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Cooperative Clinical Research--Cooperative Agreements (U10)
Project #
5U10HL051831-03
Application #
2228795
Study Section
Special Emphasis Panel (ZHL1-CCT-M (S2))
Project Start
1993-09-30
Project End
1998-08-31
Budget Start
1995-09-01
Budget End
1996-08-31
Support Year
3
Fiscal Year
1995
Total Cost
Indirect Cost
Name
Brigham and Women's Hospital
Department
Type
DUNS #
071723621
City
Boston
State
MA
Country
United States
Zip Code
02115
Brehm, John M; Ramratnam, Sima K; Tse, Sze Man et al. (2015) Stress and Bronchodilator Response in Children with Asthma. Am J Respir Crit Care Med 192:47-56
Israel, Elliot; Lasky-Su, Jessica; Markezich, Amy et al. (2015) Genome-wide association study of short-acting ?2-agonists. A novel genome-wide significant locus on chromosome 2 near ASB3. Am J Respir Crit Care Med 191:530-7
Lambert, Allison; Drummond, M Bradley; Wei, Christine et al. (2015) Diagnostic accuracy of FEV1/forced vital capacity ratio z scores in asthmatic patients. J Allergy Clin Immunol 136:649-653.e4
Wang, Y; Tong, C; Wang, Z et al. (2015) Pharmacodynamic genome-wide association study identifies new responsive loci for glucocorticoid intervention in asthma. Pharmacogenomics J 15:422-9
Dunn, Ryan M; Lehman, Erik; Chinchilli, Vernon M et al. (2015) Impact of Age and Sex on Response to Asthma Therapy. Am J Respir Crit Care Med 192:551-8
Duan, Q L; Lasky-Su, J; Himes, B E et al. (2014) A genome-wide association study of bronchodilator response in asthmatics. Pharmacogenomics J 14:41-7
Bonini, Matteo; Permaul, Perdita; Kulkarni, Tejaswini et al. (2013) Loss of salmeterol bronchoprotection against exercise in relation to ADRB2 Arg16Gly polymorphism and exhaled nitric oxide. Am J Respir Crit Care Med 188:1407-12
Kazani, Shamsah; Planaguma, Anna; Ono, Emiko et al. (2013) Exhaled breath condensate eicosanoid levels associate with asthma and its severity. J Allergy Clin Immunol 132:547-553
Tantisira, Kelan G; Damask, Amy; Szefler, Stanley J et al. (2012) Genome-wide association identifies the T gene as a novel asthma pharmacogenetic locus. Am J Respir Crit Care Med 185:1286-91
Szefler, Stanley J; Chinchilli, Vernon M; Israel, Elliot et al. (2012) Key observations from the NHLBI Asthma Clinical Research Network. Thorax 67:450-5

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