Steroid Titration Against Mannitol IN Asthma
Primary Purpose
Asthma
Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
mannitol (an airway challenge agent)
Sponsored by

About this trial
This is an interventional basic science trial for Asthma
Eligibility Criteria
Inclusion Criteria:
- Male or female asthmatics aged >/= 16 years
- Females must be non pregnant and non lactating
- FEV1 >/= 50% predicted
- Mannitol PD10 </= 635 mg at end of step down period
- No recent exacerbations of asthma requiring oral prednisolone in the previous 3 months
- Able to perform all the techniques necessary to carry out the challenge testing and lung function and compliant with taking the study medication
- Good inhaler technique which will be reinforced at each study visit
Exclusion Criteria:
- Male or female patients aged 15 or below
- FEV1 </= 50% predicted
- Patients who are currently taking a pulse of oral corticosteroids
- Patients with the following concomitant illnesses:bronchiectasis, allergic bronchopulmonary aspergillosis, COPD, heart failure, pulmonary fibrosis, rhino-sinusitis with polyps
- Immunocompromised patients
- Patients with recurrent LRTI
- Patients with documented aspirin induced asthma on LRTAs
- Pregnancy
- Known or suspected hypersensitivity to ICS or other excipients of the MDIs
- HIV/Hepatitis B or C positive
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Placebo Comparator
Active Comparator
Arm Label
Reference arm
Mannitol managed arm
Arm Description
Asthmatic patients managed as per British Thoracic Society guidelines by symptoms and lung function.
Group of asthmatic patients managed according to their mannitol challenge.
Outcomes
Primary Outcome Measures
Secondary Outcome Measures
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01216579
Brief Title
Steroid Titration Against Mannitol IN Asthma
Official Title
Titrating Inhaled Steroid Dose Against Mannitol Hyper-responsiveness or BTS Outcomes: Comparative Effects on Asthma Exacerbations Over 1 Year
Study Type
Interventional
2. Study Status
Record Verification Date
March 2008
Overall Recruitment Status
Completed
Study Start Date
March 2004 (undefined)
Primary Completion Date
February 2010 (Actual)
Study Completion Date
undefined (undefined)
3. Sponsor/Collaborators
Name of the Sponsor
University of Dundee
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The investigators hypothesise that titration of asthma medication against mannitol challenge results will reduce the number of mild asthma exacerbations, in one year, when compared with titration against BTS guidelines. To test this hypothesis the investigators propose a primary care, parallel treatment, patient blinded study in which matched groups of asthmatic patients will be treated in accordance either with BTS guidelines or with our treatment algorithm dependent on mannitol challenge result.
Purpose of the study is to evaluate the efficacy of a treatment algorithm based on the measurement of airway hyperresponsiveness to mannitol challenge, a surrogate marker of airway inflammation, in the long term treatment of asthma in comparison to BTS guidelines.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Asthma
7. Study Design
Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
164 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Reference arm
Arm Type
Placebo Comparator
Arm Description
Asthmatic patients managed as per British Thoracic Society guidelines by symptoms and lung function.
Arm Title
Mannitol managed arm
Arm Type
Active Comparator
Arm Description
Group of asthmatic patients managed according to their mannitol challenge.
Intervention Type
Other
Intervention Name(s)
mannitol (an airway challenge agent)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
16 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female asthmatics aged >/= 16 years
Females must be non pregnant and non lactating
FEV1 >/= 50% predicted
Mannitol PD10 </= 635 mg at end of step down period
No recent exacerbations of asthma requiring oral prednisolone in the previous 3 months
Able to perform all the techniques necessary to carry out the challenge testing and lung function and compliant with taking the study medication
Good inhaler technique which will be reinforced at each study visit
Exclusion Criteria:
Male or female patients aged 15 or below
FEV1 </= 50% predicted
Patients who are currently taking a pulse of oral corticosteroids
Patients with the following concomitant illnesses:bronchiectasis, allergic bronchopulmonary aspergillosis, COPD, heart failure, pulmonary fibrosis, rhino-sinusitis with polyps
Immunocompromised patients
Patients with recurrent LRTI
Patients with documented aspirin induced asthma on LRTAs
Pregnancy
Known or suspected hypersensitivity to ICS or other excipients of the MDIs
HIV/Hepatitis B or C positive
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Brian J Lipworth, MD
Organizational Affiliation
University of Dundee
Official's Role
Principal Investigator
12. IPD Sharing Statement
Citations:
PubMed Identifier
28065396
Citation
Anderson WJ, Short PM, Jabbal S, Lipworth BJ. Inhaled corticosteroid dose response in asthma: Should we measure inflammation? Ann Allergy Asthma Immunol. 2017 Feb;118(2):179-185. doi: 10.1016/j.anai.2016.11.018. Epub 2017 Jan 3.
Results Reference
derived
PubMed Identifier
22438232
Citation
Anderson WJ, McFarlane LC, Lipworth BJ. Prospective follow-up of novel markers of bone turnover in persistent asthmatics exposed to low and high doses of inhaled ciclesonide over 12 months. J Clin Endocrinol Metab. 2012 Jun;97(6):1929-36. doi: 10.1210/jc.2011-3410. Epub 2012 Mar 21.
Results Reference
derived
PubMed Identifier
21998259
Citation
Lipworth BJ, Short PM, Williamson PA, Clearie KL, Fardon TC, Jackson CM. A randomized primary care trial of steroid titration against mannitol in persistent asthma: STAMINA trial. Chest. 2012 Mar;141(3):607-615. doi: 10.1378/chest.11-1748. Epub 2011 Oct 13.
Results Reference
derived
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Steroid Titration Against Mannitol IN Asthma
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