Study compared three asthma treatments for children

Penn State Hershey’s Dave Mauger was the lead statistician of an asthma study that compared three supplemental treatments for children with persistent asthma whose symptoms were not well controlled by low doses of inhaled corticosteroids alone. Mauger is division chief of biostatistics in the Department of Public Health Sciences at Penn State College of Medicine, which was the data coordinating center for this multicenter project.

The study, called Best Add on Therapy Giving Effective Responses (BADGER), found that nearly all the 182 children, age 6 to 18 years, responded differently to the three treatments, with 45 percent of children responding best to adding a long-acting beta-agonist, 28 percent responding best to adding a leukotriene receptor antagonist, and 27 percent responding best to doubling the dose of inhaled corticosteroids.

The study also identified several patient characteristics that increased the likelihood of identifying which treatment would be more effective for an individual child.

For example, African-American study participants were equally likely to respond best to long-acting beta-agonist or inhaled corticosteroids, and least likely to respond best to leukotriene receptor antagonist.

For white participants, the addition of a long-acting beta-agonist was clearly the most likely therapy to give the best response, with inhaled corticosteroids the least favorable therapy.

In addition, a long-acting beta-agonist was more likely to be the most effective step-up (supplemental) therapy among children who started the study with high scores on the Asthma Control Test -- a five-item health survey used to measure asthma control -- and among those who did not have eczema, an allergic skin condition.

The study was conducted by researchers with the National Heart, Lung, and Blood Institute’s Childhood Asthma Research and Education Network (CARE) centers. The CARE Network was established in 1999 to evaluate treatments for children with asthma; study sites are Penn State College of Medicine, National Jewish Health, Denver; University of Wisconsin - Madison; Kaiser Permanente Medical Center, San Diego; Washington University School of Medicine, St. Louis; and University of Arizona College of Medicine, Tucson.

Results were presented at the American Academy of Asthma, Allergy and Immunology 2010 Annual Meeting in New Orleans and published online in the New England Journal of Medicine.

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Last Updated March 22, 2010