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Background:
Asthma is a heterogeneous respiratory disease and the most common chronic disease in children. A small subset of children has continuous poor asthma control despite appropriate adherence to asthma medication. There is a clinical need to identify these children as early as possible to optimize treatment and/or to find therapeutic alternatives. Therefore, the "Systems Pharmacology approach to uncontrolled Pediatric Asthma" (SysPharmPediA) study was set up.
Objective:
To establish a cohort of pediatric moderate-to-severe uncontrolled and controlled patients with asthma in order to investigate pathophysiological mechanisms underlying uncontrolled moderate-to-severe asthma in children on maintenance treatment, using a multi-omics systems medicine approach.
Methods:
In this multicenter observational case-control study, moderate-to-severe asthmatic children (n=145, age 6-17 years), were included in specialized hospitals in four European countries (Netherlands, Germany, Spain and Slovenia). Recruited subjects were selected based on good asthma control (controlled asthmatics, n=54) or poor asthma control / recurrent exacerbations (uncontrolled asthmatics, n=91). Comprehensive details concerning demographics, current and past patient/family history and clinical characteristics were collected. In addition, systems-wide omics layers, including epi(genomics), transcriptomics, microbiome, proteomics and metabolomics will be evaluated from multiple collected, relatively non-invasive, samples of from the recruited individuals, such as: blood, feces, saliva, nasal swabs and exhaled breath. Follow-up visits were performed 6 and 12 months after inclusion.
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Inclusion criteria
General:
In addition to the general criteria, a case with uncontrolled asthma (case group A) should meet:
Asthma treatment Global INitiative of Asthma (GINA) step 3 or higher
≥ 1of the following criteria (based on the guideline 'Childhood Asthma' of the section paediatric pulmonology of the Dutch Society of Paediatricians, 2007):
Frequent exacerbations requiring OCS use (≥1 in the past year) and/or
Severe exacerbations requiring hospitalization or ER visits in the past year and/or
ACQ/ACT scores indicating uncontrolled asthma
In addition to the general criteria, a case with an acute exacerbation (case group B) should meet:
In addition to the general inclusion criteria, a control (controlled asthma) should meet the following criteria:
Exclusion criteria
A patient can be re-screened 1 month after the use of the antibiotic treatment has finished.
145 participants in 2 patient groups
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Data sourced from clinicaltrials.gov
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