RECRUITING

Treating Exacerbations of Asthma With Oral Montelukast in Children

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

This research will establish a mg/kg dose for a future RCT to determine the efficacy of high-dose oral montelukast for children with moderate and severe acute asthma exacerbations. Aim: Perform an adaptive, double-masked randomized controlled trial (RCT) of high-dose oral montelukast, with escalating mg/kg dose levels determined by PK-guided dose modeling, added to standard treatment versus standard treatment alone, in children with exacerbations that are moderate or severe after initial treatment with inhaled albuterol. Hypothesis 1: High-dose oral montelukast achieves peak plasma concentration (Cmax) \>1,700 ng/ml in \>86% of at least one of three sequential participant groups with escalating weight-based (milligram/kilogram or mg/kg) doses between groups. Hypothesis 2: Participants randomized to high-dose oral montelukast have a 2 point or greater improvement of the validated Acute Asthma Intensity Research Score (AAIRS) at 4 hours post-treatment in comparison with control group participants. Hypothesis 3: Among montelukast recipients, Cmax correlates with change of the AAIRS at 4 hours, after adjustment for pre-treatment exacerbation severity and systemic leukotriene stress measured using urinary leukotriene E4 (LTE4).

Official Title

Dose Escalation Clinical Trial of High-dose Oral Montelukast to Inform Future RCT in Children With Acute Asthma Exacerbations

Quick Facts

Study Start:2023-10-20
Study Completion:2025-10-31
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT05819541

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:4 Years to 12 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:CHILD
Inclusion CriteriaExclusion Criteria
  1. * Child aged 4 - 12 years with doctor-diagnosed asthma
  2. * Presents to the Vanderbilt Children's Hospital with an acute asthma exacerbation that is moderate or severe (AAIRS \>7) after initial treatment with inhaled albuterol
  3. * The parent agrees to phone and/or mail follow-up at 2-3 weeks for completion of SCARED and side-effect questionnaires.
  1. * Gestational age \< 34 weeks
  2. * acute or chronic liver disease
  3. * allergy to montelukast
  4. * female with any evidence of Tanner stage 2 or greater breast development
  5. * gastroesophageal reflux requiring acid-blocking medication
  6. * history of anxiety disorder, depression and/or other neuropsychiatric disorder except ADHD
  7. * positive on question 1 or 2 of the Columbia Suicide Severity Rating Scale (CSSR-S)
  8. * score \>25 on the 82-point Screen for Child Anxiety Related Disorders (SCARED) questionnaire
  9. * Patients currently receiving daily montelukast (4 or 5 mg) will not be excluded from study participation.

Contacts and Locations

Study Contact

Donald H Arnold, MD, MPH
CONTACT
16155790516
don.arnold@vumc.org

Principal Investigator

Donald H Arnold, MD, MPH
PRINCIPAL_INVESTIGATOR
Vanderbilt University School of Medicine

Study Locations (Sites)

Monroe Carell Jr. Children's Hospital at Vanderbilt
Nashville, Tennessee, 37232-9001
United States

Collaborators and Investigators

Sponsor: Vanderbilt University Medical Center

  • Donald H Arnold, MD, MPH, PRINCIPAL_INVESTIGATOR, Vanderbilt University School of Medicine

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 Date2023-10-20
Study Completion Date2025-10-31

Study Record Updates

Study Start Date2023-10-20
Study Completion Date2025-10-31

Terms related to this study

Additional Relevant MeSH Terms

  • Status Asthmaticus