Guideline-defining asthma clinical trials of the National Heart, Lung, and Blood Institute's Asthma Clinical Research Network and Childhood Asthma Research and Education Network

Abstract

Due to an increasing prevalence, morbidity and mortality associated with asthma, the National Heart, Lung and Blood Institute created the Asthma Clinical Research Network (ACRN) and the Childhood Asthma Research and Education (CARE) Network to improve public health. The objectives of these clinical research networks are to conduct multiple, well designed clinical trials for rapid evaluation of new and existing therapeutic approaches to asthma and to disseminate laboratory and clinical findings to the health care community. These trials comprise a large proportion of the data driving the treatment guidelines established and reviewed by the National Asthma Education and Prevention Program. This article will review the basic design and major findings of selected ACRN and CARE Network trials involving both adults and children with asthma. Collectively, these studies have helped refine the therapeutic role of existing controller medications, establish standard models for side effect evaluation and risk-benefit models, validate symptom based assessments for asthma control, and identify baseline characteristics that may predict individual patient responses. Remaining challenges include shaping the role of novel therapeutics in future guidelines, incorporating pharmacogenomic data in treatment decisions, and establishing better implementation strategies for translation to community settings, all with the goal of reducing the asthma burden on society.

Asthma in Children at the Pediatric Intensive Care Unit of University Hospital of Brazzaville (Congo)

“…The exacerbation of asthma was defined by the persistence of the crisis beyond 24 hours. As before, this exacerbation was classified as a mild, moderate and severe crisis [6] [7].…”

“…It is now admitted [6] [22] [23], on the one hand that short-acting β-mimetics are first-line treatment irrespective of the age of the child or the level of severity of the crisis, and on the other that their preferred way of administration is the inhaled route.…”

P2X7-Regulated Protection from Exacerbations and Loss of Control Is Independent of Asthma Maintenance Therapy

“…Details of these trials have been previously published (28)(29)(30). Table E1 in the online supplement also has basic descriptors of these cohorts.…”

Advances in pediatric asthma in 2007

“…The networks have been successful doing this and also recognizing variability of treatment response, factors that modify response to treatment, and potential predictors of treatment response, such as biomarkers and genetics. The accomplishments of ACRN and the CARE Network over the past 15 years were summarized in a review by Denlinger et al 17 One of the recent ACRN trials attempted to identify asthma characteristics and biomarkers associated with ICS response in adults. 18 This study found that the only strong predictors of ICS response were albuterol reversibility and FEV 1 /forced vital capacity.…”