TERMINATED

Tiotropium vs. Inhaled Corticosteroids in Children With Nonatopic Asthma Pilot Study (TioNAAP)

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

Most children with asthma have concurrent atopy (allergic inflammation), which is associated with an improved response to ICS. However, the absence of an atopic phenotype is associated with a poorer ICS response, leaving clinicians with limited treatment options. The nonatopic asthma phenotype has been characterized as the absence of atopic diseases including allergic rhinitis, eczema, or food allergies, and a negative skin prick test to common aeroallergens. Children with mild asthma treated with ICS over 44 weeks without a positive allergen skin test are 3 times more likely to have an asthma exacerbation when compared with children with positive skin tests. Similarly, adolescents and adults with asthma with low blood eosinophils or low sputum eosinophils have no difference in exacerbation rate response to ICS compared with placebo. Due to poor ICS response in nonatopic children and the known adverse effects of ICS, the development of non-steroid treatments options is needed. Monotherapy with the long-acting muscarinic antagonist, tiotropium, was superior to placebo for treatment failure outcomes in adolescents and adults with low sputum eosinophil levels. Tiotropium is approved in children as an add on therapy to ICS in children ≥ 6 years with asthma. But, this combination of treatment would still expose children with nonatopic asthma to the risks (but potentially without the benefit) of ICS therapy. The objective of this study is to conduct a feasibility pilot safety study of 6-weeks treatment with tiotropium monotherapy vs. ICS in children ages 6 to 11 years old with nonatopic mild persistent asthma.

Official Title

Tiotropium vs. Inhaled Corticosteroids in Children With Nonatopic Asthma Pilot Study

Quick Facts

Study Start:2022-01-01
Study Completion:2025-10-31
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:TERMINATED

Study ID

NCT04990167

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:6 Years to 11 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:CHILD
Inclusion CriteriaExclusion Criteria
  1. 1. Children ages 6 to 11 years with controlled mild nonatopic persistent physician diagnosed asthma
  2. 1. Non-atopic asthma: absence of a positive SPT to inhaled aeroallergens or negative specific IgE to a common regional allergen panel; historical serum IgE less than 200 IU/ml; historical serum eosinophils less than 350 cells per microliter (cells/mcL); no history of eczema; no history of allergic rhinitis; no history of food allergy
  3. 2. Physician-diagnosed asthma: positive family history, recurrent asthma symptoms, bronchodilator responsiveness, and evidence of obstruction.
  4. 3. Mild persistent asthma: current treatment with as-needed albuterol or low-dose ICS or daily montelukast (Step 2 therapy)
  5. 4. Controlled asthma: Childhood Asthma Control Test score \>19
  6. 2. Pre-bronchodilator FEV1 ≥ 80% of predicted
  1. 1. Oral corticosteroid use in the past 6 weeks
  2. 2. Use of ICS in combination with long-acting beta agonist or montelukast
  3. 3. History of life-threatening asthma requiring treatment with intubation or mechanical ventilation within the past 5 years
  4. 4. Respiratory tract infection within the past 4 weeks
  5. 5. Any other chronic diseases or medical conditions (other than asthma) that in the opinion of the investigator would prevent participation in a trial

Contacts and Locations

Principal Investigator

Gerardo A Vazquez Garcia, MD
PRINCIPAL_INVESTIGATOR
Nemours

Study Locations (Sites)

Nemours Specialty Care
Jacksonville, Florida, 32207
United States

Collaborators and Investigators

Sponsor: Nemours Children's Clinic

  • Gerardo A Vazquez Garcia, MD, PRINCIPAL_INVESTIGATOR, Nemours

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2022-01-01
Study Completion Date2025-10-31

Study Record Updates

Study Start Date2022-01-01
Study Completion Date2025-10-31

Terms related to this study

Keywords Provided by Researchers

  • Nonatopic

Additional Relevant MeSH Terms

  • Asthma in Children