Asthma In Children And Other Recent Asthma Research Findings Presented

NHLBI Asthma Clinical Research Networks

Two of the presentations included new research findings from the Prevention of Early Asthma in Kids (PEAK) study, which is investigating the effect of inhaled-corticosteroid therapy on children with asthma. In May 2006, PEAK researchers published findings in The New England Journal of Medicine that showed that preschool children at high risk for asthma had decreased asthma-like symptoms while on two years of inhaled-corticosteroid therapy; however, this therapy did not change the development of asthma symptoms or lung function during a third, treatment-free year.

Since then, the researchers have continued to observe the 285 children in the study, to get a more in-depth look at the changes in the lungs, including inflammation, in these children. The new PEAK results will look at the follow-up of the study, with more in-depth information about the predictors of response to inhaled steroids and long-term changes in the physiology of the lung.

Wayne Morgan, M.D., of the University of Arizona Health Sciences Center in Tucson, presented new data at the ATS meeting, comments, "The question was, can you protect the airways by using inhaled steroids early in life in high-risk kids to modify the development of wheezing and protect lung function" The bottom line is no. You can control asthma, but you can't make it go away." In this study, children considered to be at high risk of asthma include those with recurrent wheezing in the first three years of life, as well as those with eczema or a parent with asthma.

A second presentation on the PEAK study looked at whether there are ways to predict which high-risk children will do poorly with their asthma. "Some children outgrow their asthma and some maintain their asthma, and PEAK found that inhaled steroids didn't change that course. However, these high-risk children do respond to inhaled steroids, but if you take them off, they tend to do worse," says researcher Theresa Guilbert, M.D., Assistant Professor of Pediatrics at the University of Wisconsin-Madison and lead author of The New England Journal of Medicine article. "We know that if children have certain characteristics such if they're male, have allergy, or have eczema that they tend to do poorly over time."

A third study from NHLBI's Asthma Clinical Research Network looked at the impact of overweight and obesity on asthma severity and response to asthma therapy. The study used data from the NHLBI on approximately 1,200 people with asthma.

"This type of study provides extremely rich data in terms of the participants' height, weight and asthma severity, allowing us to more precisely evaluate the relationship between body mass and asthma severity," says researcher E. Rand Sutherland, M.D., M.P.H., Assistant Professor of Medicine at the National Jewish Medical and Research Center in Denver. "We can also look at how obesity modifies the response to therapy."

Dr. Sutherland's findings suggest that in patients with mild-to-moderate asthma, increased weight does not substantially worsen physiologic and inflammatory markers of asthma. "However, overweight and obese patients with asthma do appear to respond less well to traditional asthma therapies than do their lean counterparts," he says.