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Asthma Phenotypes in the Inner City

Information source: National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Asthma

Intervention: Flovent Diskus, Advair Diskus, Ventolin HFA, cetirizine, Flonase Nasal Spray, Singulair (Drug)

Phase: N/A

Status: Active, not recruiting

Sponsored by: National Institute of Allergy and Infectious Diseases (NIAID)

Official(s) and/or principal investigator(s):
William W. Busse, MD, Study Chair, Affiliation: University of Wisconsin, Madison

Summary

Asthma is a complex, heritable disease that affects more than 11. 2% of the U. S. population, which represents approximately 9 million children and 23 million adults. Although the underlying characteristics of asthma exist in virtually all patients, the clinical expression of the disease and response to treatment are highly variable. The purpose of this study is to identify characteristics of participants who have difficult to treat asthma and those who have easy to treat asthma. It is hoped that this study will provide information about these characteristics that will lead to better and improved treatment for individuals with asthma.

Clinical Details

Official title: Asthma Phenotypes in the Inner City (ICAC-19)

Study design: Observational Model: Cohort, Time Perspective: Cross-Sectional

Eligibility

Minimum age: 6 Years. Maximum age: 17 Years. Gender(s): Both.

Criteria:

Inclusion Criteria: Participants who meet all of the following criteria are eligible for enrollment. Participants may be reassessed if not initially eligible. Participants are eligible if they: 1. Male or female aged 6-17 years, inclusive, at recruitment. 2. Have a physician diagnosis of asthma. 3. Have had 2 or more episodes of short-acting beta-agonist administration within the past 12 months, exclusive of use associated with exercise-induced symptoms. 4. Have a primary place of residence located in one of the pre-selected recruitment census tracts as defined in the APIC Manual of Operations. 5. Meet pretreatment eligibility requirements for trial enrollment (acceptable medical history and physical examination results). 6. Have a parent or legal guardian who is willing to sign the written Informed Consent prior to initiation of any study procedure. 7. Are willing to sign the assent form, if age appropriate. 8. Have medical insurance at the Screening Visit. Coverage must be in effect from Screening through Enrollment in order to be enrolled. Exclusion Criteria: Participants who meet any of the following criteria are not eligible for enrollment but may be reassessed. Participants are ineligible if they: 1. Have had 2 or more life-threatening asthma exacerbations in the last 2 years requiring intubation or mechanical ventilation, or resulting in a hypoxic seizure. 2. Are pregnant or lactating. (Females of child-bearing potential must remain abstinent or use a medically acceptable birth control method (e. g. oral, subcutaneous, mechanical, or surgical contraception) throughout the study. This is not for safety, but because it may be difficult to assess asthma control since lung function may change, making it difficult to interpret outcome measures). 3. Will not allow the study clinician to manage their disease for the duration of the study or who are not willing to change their asthma medications to follow the protocol. 4. Are unable to use a metered-dose inhaler (MDI) for administration of a beta-agonist rescue medication or use a dry powder inhaler (DiskusĀ®) for the administration of asthma controller regimens. 5. Are currently receiving hyposensitization therapy or have received hyposensitization therapy to any allergen in the past year prior to recruitment 6. Are currently participating in an asthma-related pharmaceutical study or intervention study or who have participated in another asthma-related pharmaceutical study or intervention study in the month prior to recruitment. 7. Do not sleep at least 4 nights per week in the same home. 8. Have a sibling or other person living in the same home enrolled in the study. 9. Live with a foster parent; not applicable if participant is able to provide consent. 10. Do not have access to a phone (needed for scheduling appointments). 11. Who are currently taking, or who have taken any of the following medications within 4

weeks of the Screening Visit (Visit - 1): Monoamine oxidase inhibitors (phenelzine,

tranylcypromine); Tricyclic and tetracyclic antidepressants; beta adrenergic blocker drugs (both oral and topical); Anticonvulsants (carbamazepine, phenobarbital, phenytoin, mephobarbital, primidone, ethosuximide, methsuximide, felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, tiagabine, topiramate, valproic acid, divalproex sodium, zonisamide); Protease inhibitors (ritonavir, indinavir, nelfinavir); Calcium channel blockers (verapamil, diltiazem); Modafinil; Tamoxifen; non-nucleoside reverse transcriptase inhibitors; Macrolide antibiotics* (erythromycin, clarithromycin, dirithromycin, troleandomycin); chloramphenicol; nefazodone; aprepitant; St John's Wort; Rifampin*; Azole Antifungals* (ketoconazole, fluconazole, itraconazole); Sibutramine* ; bergamottin (constituent of grapefruit juice) (*may be rescreened if this therapy is short-lived). 12. Should not be included in the study for any other reason, according to the investigator's discretion. This would include when, in the judgment of the investigator, the clinical care of the participant would be compromised by the treatment algorithm. 13. Are receiving treatment with omalizumab, or have had omalizumab treatment within three months prior to screening. 14. Are not able to perform spirometric pulmonary function tests (PFTs)

15. Are not adherent to the controller medication between Visit - 1 and Visit 0 (defined

as medication use less than 50%, see Section 6. 6 for determining treatment adherence). Participants who meet any of the following criteria are not eligible for enrollment and may not be reassessed. Participants are ineligible if they: 16. do not primarily speak English (or Spanish at centers with Spanish speaking staff). Exclusion also applies to the child's caretaker. 17. Plan to move from the area during the study period (13 months). 18. Have any medical illnesses that in the opinion of the investigators would a.) increase the risk the subject would incur by participating in the study; b.) interfere with the measured outcomes of the study; or c.) interfere with the performance of the study procedures. Examples of such diseases are: phenylketonuria, cystic fibrosis, bronchiestasis, type 1 diabetes, hemophilia, Von Willebrands disease, sickle cell disease, cerebral palsy, rheumatoid arthritis, lupus, psoriasis, hyperimmunoglobulin E syndrome, parasite infections, Wiskott-Aldrich Syndrome or allergic bronchopulmonary aspergillosis. 19. Have known hypersensitivity to any of the medications that will be used for the treatment of asthma or rhinitis. 20. Have a current, severe hypersensitivity to milk 21. Have a current diagnosis of cancer, are currently being investigated for possible cancer, or who have a history of cancer.

Locations and Contacts

National Jewish Health, Denver, Colorado 80206, United States

Children's National Medical Center, Washington, District of Columbia 20010, United States

Children's Memorial Hospital, Chicago, Illinois 60614, United States

Johns Hopkins University, Baltimore, Maryland 2105, United States

Boston University School of Medicine, Boston, Massachusetts 02118, United States

Henry Ford Health Center, Detroit, Michigan 48202, United States

Columbia University Medical Center, New York, New York 10032, United States

Cincinnati Children's Hospital, Cincinnati, Ohio 45202, United States

University of Texas Southwestern Medical School, Dallas, Texas 75390, United States

Additional Information

Starting date: August 2011
Last updated: September 11, 2013

Page last updated: August 23, 2015

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