News Release

Study aims to prevent asthma

Peer-Reviewed Publication

National Jewish Health

Asthma rates have more than doubled since 1980, and there is no known cure. But doctors at National Jewish Medical and Research Center think they may be able to prevent asthma from developing in children at high risk for the disease. By treating airway inflammation at the earliest stages, researchers at National Jewish and five other medical centers hope to prevent permanent changes to the airways that lead to chronic asthma.

“The majority of asthma patients develop their first symptoms as children, and most suffer the disease for the rest of their lives,” said Stanley Szefler, M.D., principal investigator for the study at National Jewish. “We believe there is a critical period when we can stop the disease process and prevent asthma from taking hold.” The Prevention of Early Asthma in Kids (PEAK) study will enroll children ages 2 to 4 who have had wheezing episodes in the previous year and have one additional risk factor, such as eczema, allergies, or a parent with asthma. Study participants will take the inhaled steroid fluticasone (Flovent) or an inactive inhaler as placebo twice daily for two years. After two years, patients will be taken off the study medication and observed for one year to see if they develop any asthma symptoms. All study participants will also receive standard medical care for any respiratory problems they experience. Asthma is a chronic respiratory disorder characterized by swollen airways and recurrent episodes of bronchial constriction that severely obstruct airflow in and out of the lungs. Nearly 15 million Americans suffer from asthma. Approximately 75 percent of all asthmatics first develop the disease in childhood.

Scientists do not know what causes asthma, nor do they completely understand the early stages of the disease. They do believe a genetic predisposition coupled with unknown environmental exposures first causes inflammation, which then progresses into chronic asthma. Steroids have been shown to be safe and effective treatment for asthma symptoms in children as young as 1 year of age. Studies in older children show that steroids seem to have little effect on the natural course of the disease; once the steroids are discontinued, asthma symptoms return.

Some studies have suggested that irreversible changes in the airways occur in the very early stages of the disease, often before it is diagnosed and before steroids are prescribed, that establish the long-term course of the disease. PEAK researchers plan to begin steroidal treatment early in the disease process to see if they can stop the inflammation from causing those irreversible changes.

“I use the snowball analogy,” said Joseph Spahn, M.D., PEAK co-investigator at National Jewish. “It is much easier to stop a small snowball that has been rolling for a few inches than it is to stop a much larger one that has been rolling for 100 yards. Asthma is like a snowball that begins with some wheezing and inflammation, then progresses to a much bigger problem with more severe inflammation and hyperresponsive bronchial muscles. By treating the earliest stages of inflammation we hope to stop the snowball of asthma before it gets a chance to gain momentum. With luck we will be able to completely prevent asthma.”

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National Jewish is one of six medical centers participating in the PEAK study, which is funded by the National Heart Lung and Blood Institute, one of the U.S. National Institutes of Health. The other participating medical centers are at the University of Arizona, University of California San Diego, Pennsylvania State University, Washington University and the University of Wisconsin.

To learn more about the PEAK study, call 303-270-2267. You can also visit http://www.asthma-carenet.org/clinicaltrials/peak.html or call LungLine at 800-222-LUNG.


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