Researchers Looking for Best Asthma Treatment for Children

When pediatricians first diagnose a child with asthma, they are faced with a difficult choice. Which medication is the best, first choice for controlling the disease? Several options exist, but no significant studies have compared them head-to-head in children. Until now. Researchers at National Jewish Medical and Research Center are beginning a study to compare the three most commonly prescribed medication regimes for the treatment of asthma in children ages 6 to 13.

"This study should answer a very basic and important question," said Stanley Szefler, MD, the study's principal investigator at National Jewish. "What is the first-line treatment of choice in children with mild-to-moderate persistent asthma? The answer will help guide treatment for millions of patients."

Inhaled steroids are considered the gold standard for controlling asthma, but many patients are concerned about potential side effects from these drugs. Two alternative classes of drugs, long-acting beta agonists and leukotriene modifiers, have come on the market in recent years and may offer advantages over inhaled steroids alone.

In a year-long study funded by the National Heart, Lung, and Blood Institute, researchers at National Jewish and four other research centers around the country will compare the ability of an inhaled steroid (Flovent Diskus), a lower dose of inhaled steroid combined with a long-acting beta agonist (Advair Diskus), and a leukotriene modifier (Singulair) to control asthma symptoms in children with mild to moderate asthma.

In addition to gathering basic data about which medication works best for most children, the researchers will also gather a raft of additional information they hope will offer more specific guidance about which medications may work best for which children.

"Not all children respond the same way to the same medications," said Dr. Szefler. "We are planning very detailed evaluations of each child's condition so we can look for markers that may help further guide medication choices."

In a departure from many studies in the past, none of the children will receive a placebo; each child will receive one of the study medications. In recent years, researchers have increasingly come to believe that the additional scientific benefit of a placebo-controlled study is not great enough to warrant withholding medication from children with asthma. Patients in the study will also be able to continue taking their rescue medications during the study, primarily inhaled albuterol.

National Jewish is now enrolling patients in the study. Enrollees will have to visit National Jewish seven times for one to two and a half hours each time and participate in three telephone calls during the 50-week study. Patients will receive all medications free of charge. In addition, families will be given action plans to guide management of any worsening symptoms, asthma education and detailed clinical evaluations of the children's asthma. Both parents and children will also receive financial compensation for their time. Anyone interested in enrolling in the study, known as Pediatric Asthma Controller Trial (PACT), can call 303-270-2267 or 800-423-8891, ext. 2267

Founded in 1899, National Jewish is the only medical and research center in the United States devoted entirely to respiratory, allergic and immune system diseases, including asthma, tuberculosis, emphysema, severe allergies, lupus and other autoimmune diseases. For general information regarding allergic, respiratory and immune system diseases call 1-800-222-LUNG (5864) and talk to a LungLine nurse.