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Inflammatory, Functional and Image Composite Measure to Define Asthma Control (APITA)

16. januar 2008 opdateret af: Federal University of São Paulo

The goals of control status of asthma have been changed with the improvement of its management as a chronic disease; many steps should be taken to achieve asthma control as defined by the GINA/NIH guidelines. There are good results with single variables, but overall asthma control should be addressed in different ways. Most traditional clinical studies provide an incomplete assessment of disease control, despite good clinical practice. The association of inhaled corticosteroid (IC) and long-action beta 2 agonist (LABA) has already showed their efficacy to reduce asthma symptoms, exacerbations and cost for moderate and severe asthma patients as well as the improvement in their quality of life. On the other hand, even with the use of first line maintenance medication, as recommended by guidelines, some asthmatic patients fail in obtaining a total control of the disease. This lack of efficacy, led us to hypothesize, that these patients who fail in response, would present chronic and fixed airway obstruction as a consequence of persistent inflammation and airway remodeling. This study has the purpose of looking for an adequate composite measure to provide an indicator of overall asthma status more accurately and meaningfully as reflect of treatment effectiveness and disease control. For this, we will test by a randomized control trial if an additional oral corticosteroid treatment could modify spirometric and plethysmography values, nasal and low airway cytology and HRCT (to evaluate small airway) in regularly treated stable asthma patients who have a positive bronchodilator response.

Studieoversigt

Status

Ukendt

Betingelser

Astma

Intervention / Behandling

Medicin: prednisone

Detaljeret beskrivelse

To evaluate the achievement of asthma control status in asthmatic patients, regularly treated with IC + LABA to answer the following questions:

i. Is it possible to improve the pulmonary function (spirometry and plethysmography) of stable asthma patients, regularly treated with IC + LABA, who have a positive bronchodilator response, with the introduction of oral steroid?

ii. What is the relationship among nasal, induced sputum and blood cytology, as a tool to observe inflammatory airway expression, in controlled and total controlled asthma patients? What will be these values response if oral steroids have been introduced?

iii. What is the correlation between pulmonary volumes and airways inflammation to evaluate severity and control status in asthmatic patients, using plethysmography and HRCT? What will be these values response if oral steroids have been introduced?

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

Fase

Fase 4

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

Brasilien
- Sao Paulo
  - São Paulo, Sao Paulo, Brasilien, 04023062
    - Rekruttering
    - Rua Botucatu 740 3 ° and - Pneumologia
    - Kontakt:
      
      Maria Marta F Amorim, MSc
      
      Telefonnummer: 55 11 50841268
      
      E-mail: martafamorim@terra.com.br
    - Kontakt:
      
      Patricia B Lima, Techinician
      
      Telefonnummer: 55 11 50841268
      
      E-mail: patricia@pneumo.epm.br
    - Ledende efterforsker:
      
      Ana Luisa G Fernandes, MD, PhD
    - Underforsker:
      
      Alexander Araruna, MD
    - Underforsker:
      
      Maria Marta F Amorim, MSc

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

16 år til 80 år (Barn, Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion criteria:

A documented clinical asthma history at least for a period of six months
Regular treatment (IC + LABA) at least for a period of three months
Controlled symptoms score defined by GINA 2002 criteria (daytime symptoms < 2 days a week and no night time symptoms in the last 15 days) or complete absence of chronic symptoms
None or minimal exacerbations without emergency visits
Absent or a minimal usage bronchodilator rescue, side effects of medication and limitation to exercises
Documented airway reversibility of 200 ml and 7% based on predicted values of VEF1

Exclusion Criteria:

Having a smoking history of 5 pack/years or more; having other known chronic pulmonary diseases; having side effect to oral corticosteroid
Having an upper or lower respiratory tract infection within 4 weeks of visit 0
Unable to do the tests involved in the study.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Primært formål: Behandling
Tildeling: Randomiseret
Interventionel model: Enkelt gruppeopgave
Maskning: Firedobbelt

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål	Tidsramme
Asthma control status characterized by nocturnal and diurnal symptom score FEV1,total lung capacity in plethysmography and reducing the air-tapping in HRCT. Tidsramme: 30 days	30 days

Sekundære resultatmål

Resultatmål	Tidsramme
Quality of life, Sputum and nasal cytology, adverse events Tidsramme: 30 days	30 days

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Federal University of São Paulo

Samarbejdspartnere

Fundação de Amparo à Pesquisa do Estado de São Paulo

Efterforskere

Ledende efterforsker: Ana Luisa G Fernandes, MD, PhD, Federal University of São Paulo

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Hjælpsomme links

University home page

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. juli 2006

Primær færdiggørelse (Forventet)

1. marts 2008

Studieafslutning (Forventet)