Research Targets Best Treatments For Childhood Asthma, UK

Main Category: Respiratory / Asthma
Also Included In: Pediatrics / Children's Health
Article Date: 07 Feb 2008 - 2:00 PDT

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Asthma affects one in eight children in the UK. New research projects commissioned by the National Institute for Health Research's Health Technology Assessment (NIHR HTA) programme, costing more than £1million, will investigate the best treatments for children with both long-term asthma and severe acute attacks of asthma.

Researchers at the British Paediatric Respiratory Society, led by Professor Warren Lenney, will assess the best ways to manage asthma in children for whom inhaled low dose steroids (the standard first line treatment) are not working. The trial will investigate the clinical and cost-effectiveness of the three alternative treatment strategies that are outlined in the National Asthma Guidelines: a steroid inhaler, an inhaler containing a steroid combined with a long-acting reliever, or a steroid inhaler combined with a leukotriene receptor antagonist tablet.

The research will involve 900 children aged seven -15. To measure response to the different treatments, the children and their parents will fill in questionnaires which reflect asthma symptom control.

"Much of the available research evidence about treatments for asthma involves trials of adults. But children experience very different asthma symptoms than adults so it is vital that research involving children is carried out," says Professor Lenney. "What matters to children is how they feel, and whether they are able to run around and play with friends and go to school. We aim to identify which of these treatments is best to achieve this."

The second trial funded by the HTA programme will investigate whether nebulised magnesium is a clinical and cost-effective addition to standard treatment, nebulised salbutamol and ipratropium, in children with acute severe asthma. The Magnesium Nebuliser Trial In Children (MAGNETIC) trial, led by Dr Colin Powell of the Children's Hospital for Wales, involves 500 children aged two -16.

"A number of studies examining nebulised magnesium have found it to be effective for treating acute asthma in adults, but evidence about its effectiveness for children is limited," says Dr Powell. "Current guidelines require that, if inhaled treatment is unsuccessful, the next step is to start intravenous treatment. If this study shows that children respond to nebulised magnesium at this stage, invasive intravenous treatment could be avoided."

These studies are among the first funded by the HTA programme as a result of a special call for research proposals in the area of medicines for children. The programme has commissioned a portfolio of research into the area to support the work of the new Medicines for Children Research Network, set up to target the development of safe and effective medicines for children, a largely neglected area. For more details about these projects visit http://www.hta.ac.uk/1599 and http://www.hta.ac.uk/1615

Notes

1. The HTA programme is a programme of the National Institute for Health Research (NIHR) and produces high quality research information about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest of the NIHR programmes and publishes the results of its research in the Health Technology Assessment journal, with more than 400 issues published to date. The journal's 2006 Impact Factor (5.29) ranked it in the top 10% of medical and health-related journals. All issues are available for download free of charge from the website, http://www.hta.ac.uk The HTA programme is coordinated by the National Coordinating Centre for Health Technology Assessment (NCCHTA), based at the University of Southampton.

2. The National Institute for Health Research provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility. The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the government and its partners alongside high-quality patient care, education and training. Its aim is to support outstanding individuals (both leaders and collaborators), working in world class facilities (both NHS and university), conducting leading edge research focused on the needs of patients.

National Institute for Health Research