Study Will Try to Prevent Asthma in Children

Six U.S. medical centers will take part in a major two-year study that will attempt to prevent asthma in children at high risk for the disease. By treating airway inflammation at the earliest stages, researchers hope to prevent the permanent airway changes that lead to chronic asthma. The name of the study is PEAK (Prevention of Early Asthma in Kids).

In the study, researchers will enroll children of two to four years old who have had wheezing episodes in the previous year and who have one additional risk factor, such as eczema, allergies, or a parent with asthma. The children will be treated with the inhaled steroid fluticasone or an inactive inhaler as placebo twice daily for two years. Afterward, the children will be observed for one year to see if they develop asthma symptoms.

About 75% of asthmatics first develop the disease in childhood. The cause is unknown. Scientists believe a genetic predisposition coupled with environmental exposures first causes inflammation, which then progresses into chronic asthma. Steroids have been shown to be a safe, effective treatment for asthma symptoms in children as young as one year of age. Studies in older children, however, show that steroids seem to have little effect on the natural course of the disease, so that asthma symptoms return when steroids are discontinued. Other studies have suggested that irreversible changes in the airways occur in the very early stages and establish the long-term course of the disease. The PEAK researchers will try to prevent these irreversible changes.

"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,” said Joseph Spahn, M.D., co-investigator at National Jewish Medical and Research Center (Denver, CO, USA), one of the participating medical centers. "By treating the earliest stages of inflammation, we hope to stop the snowball of asthma before it gets a chance to gain momentum.”




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