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New study examines kids

Washington University In St Louis : 03 January, 2002  (Technical Article)
Pediatric researchers at Washington University School of Medicine in St. Louis are collaborating in a new national study to determine how to identify the best asthma medications for particular patients. Children with mild to moderate asthma may be eligible to participate in the study. This research is the first of its kind to examine how individual differences affect the body
Using the two top-selling asthma control medications in the United States, Flovent and Singulair, researchers seek to learn why some patients respond better to one of the medications than the other. They will look at genetic differences, asthma history, allergen skin test results and other characteristics that vary from one person to another. The two drugs are well established, so the study will not examine whether one drug is more effective than the other.

“It’s becoming increasingly clear that different patients with the same illness respond to different medications,” says Leonard B. Bacharier, M.D., co-principal investigator of the St. Louis site. “We need to get a sense of why this happens.” Bacharier is assistant professor of pediatrics.

Before any new medication is approved for use, extensive testing is done to ensure that it is safe and effective. But those studies rarely use genetic information to understand why a particular drug works well for one person but not for someone else.

Asthma is a chronic disease caused by inflammation and swelling of the small airways in the lungs. The swollen airways become congested with mucus, and muscle spasms around the airways block the normal flow of air, causing the person to cough, wheeze and have difficulty breathing.

To qualify for the study, children must have mild to moderate asthma and be between ages 6 and 17. Once enrolled, participants in the five-month study will inhale fluticasone propionate (Flovent) and take a montelukast pill (Singulair), each for eight weeks. Throughout the study, participants will take albuterol as needed for asthma symptoms. To be sure the study’s results are not distorted, children, parents and researchers will not know which medication is given at any given time.

Participants will receive compensation for each study visit, located at St. Louis Children’s Hospital.

“One of the challenges of managing kids with asthma is that we have a variety of medications available to us,” says Bacharier. “Each of them has their attractive sides and each has their side effects. In this study, we’re going to let the characteristics of each person tell us which medication makes more sense for one patient and less sense for another patient.”

Researchers aim to enroll 140 children at five centers nationwide, including 28 children at the St. Louis site. Results from the study, funded by the National Institutes of Health, could help physicians better tailor medications to people most likely to respond to them.
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