- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT00200980
Importance of Non-Acid Reflux in Asthma in Children
Importance of Non-Acid Reflux in Moderate and Severe Asthma
Studieoversigt
Status
Betingelser
Detaljeret beskrivelse
Research Plan
Hypothesis and Specific Aims:
Asthma and gastroesophageal reflux are both common medical conditions in infants and children as in adults, and often co-exist (Gibson 2002, Andze, 1991). Though an association with overt reflux disease and asthma is well described and accepted, occult acid reflux has also been shown to be associated with asthma. The vexing question has been whether non-acidic reflux exacerbates asthma, particularly moderate to severe asthma. Current approaches and the extensive literature to date have dealt with the role of acid reflux only, and hence medical management is dominated by gastric acid suppression strategies recently outlined by a consensus statement from the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (Rudolph 2001). Based on this consensus, and randomized double blind studies in adults, our strategy is to now use long-term proton pump inhibitors. Clinically, this intervention has limited impact, and treatment failures are common. Now that non-acid gastroesophageal reflux can be measured with the combined impedance and pH probe, the role of non acid reflux can finally be evaluated. Our experience thus far confirms findings of limited published pediatric studies using a significant role for non-acid reflux in these "non -responders", and indeed suggests a greater role of non-acid GER in extra-esophageal disorders in general. This new tool supercedes the standard pH probe. Currently the standard of care for moderate to severe asthma is evaluation for association with gastroesophageal reflux. These cases at NCC-Wilmington undergo 24 hour combined impedance and pH study. With the advent of this new tool at NCC-Orlando also, we plan to combine resources at several sites to accumulate data on prevalence of acid and non-acid reflux in asthma. This would be an effective use of data retrieval attributes of EPIC. Future studies looking at the impact of type of refluxate on bronchospasm, parenchymal damage, and even chronic pulmonary vascularity changes prospectively would then be set up. Since currently we have no specific recommendations for medical treatment of non-acid GER, therapeutic strategies, either with existing or newer motility agents, could also be evaluated in the future to develop practice guidelines.
Specific Aim:. What is the prevalence of acid and non-acid GER in moderate to severe asthma patients referred for GI evaluation
Prevalence of acid and non-acid gastroesophageal reflux in children 1 to 18 yrs with moderate asthma and severe asthma, referred for evaluation of gastroesophageal reflux at NCC-Wilmington, New Jersey, and NCC-Orlando will be obtained. This information will be extracted from EPIC templates that have current standards of care incorporated.
Undersøgelsestype
Tilmelding (Forventet)
Kontakter og lokationer
Studiesteder
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Florida
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Orlando, Florida, Forenede Stater, 32801
- Nemours Children's Clinic
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
Moderate to Severe Asthma in Children 1 - 18 years
Exclusion Criteria:
Antireflux surgery Unable to have 24 hr reflux study completed
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Samarbejdspartnere og efterforskere
Sponsor
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Devendra I Mehta, Nemours Children's Clinic
Datoer for undersøgelser
Studer store datoer
Studiestart
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Sygdomme i fordøjelsessystemet
- Luftvejssygdomme
- Sygdomme i immunsystemet
- Lungesygdomme
- Overfølsomhed, Øjeblikkelig
- Gastrointestinale sygdomme
- Bronchiale sygdomme
- Lungesygdomme, obstruktiv
- Respiratorisk overfølsomhed
- Overfølsomhed
- Esophageal Motilitetsforstyrrelser
- Deglutition lidelser
- Esophageale sygdomme
- Astma
- Gastroøsofageal refluks
Andre undersøgelses-id-numre
- 0504609
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