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Phase 3 N=342 Randomized Quadruple-blind Treatment

Asthma Clinical Research Network (ACRN) Trial - Best Adjustment Strategy for Asthma in Long Term (BASALT)

Asthma

Enrolled (actual)
342
Serious AEs
2.1%
Results posted
May 2012
Primary outcome: Primary: Time to Treatment Failure (Measured in Days) — 196.9; 225.2; 182.3 days

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Symptom-based adjustment (Behavioral); Biomarker-based adjustment (Behavioral); Guideline-based adjustment (Behavioral)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Milton S. Hershey Medical Center
Primary completion
Jul 2010

Outcome Measures

OutcomeResultp-value
PRIMARY
Time to Treatment Failure (Measured in Days)
196.9; 225.2; 182.3
SECONDARY
Number of Episodes of Treatment Failure
SECONDARY
Time to First Asthma Exacerbation
SECONDARY
Number of Asthma Exacerbations
SECONDARY
Tests of Airway Caliber and Responsiveness (Forced Expiratory Volume in One Second (FEV1) Pre- and Post-bronchodilator Inhalation), Methacholine Provocative Concentration at 20% (PC20)
SECONDARY
Tests of Airway Inflammation (Exhaled Breath Condensate (EBC), Fractional Exhaled Nitric Oxide (FeNO), Sputum Eosinophils)
SECONDARY
Quality-of-life (AQLQ), Asthma Control Questionnaire (ACQ), and Number of Visit Days That ACQ is Less Than 1.25
SECONDARY
Total Amount of Oral Prednisone Required and Total Amount of Inhaled Steroids
SECONDARY
Adverse Events

Summary

Asthma can be effectively controlled using inhaled corticosteroid medication. Treatment with inhaled corticosteroids often requires periodic adjustments to medication dosing and frequency levels. This study examines whether it is more beneficial to adjust corticosteroid treatment based on asthma symptoms and/or biomarkers of lung function versus standard medical guidelines.

Eligibility Criteria

Inclusion Criteria for BASALT and TALC Studies:

  • Clinical history consistent with asthma
  • Forced expiratory volume in one second (FEV1) greater than 40% of predicted value
  • Asthma confirmed by one of the following two criteria:
  • Beta-agonist reversibility to 4 puffs albuterol of at least 12% OR
  • Methacholine provocative concentration at 20% (PC20) FEV1 of 8 milligrams per millimeter (mg/mL) or less when not on an inhaled corticosteroid, or 16 mg/mL or less when on an inhaled corticosteroid
  • Need for daily controller therapy (i.e., inhaled corticosteroids, leukotriene modifiers, and/or long-acting beta-agonists) based on one or more of the following criteria:
  • Received prescription for or used asthma controller within the 12 months prior to study entry OR
  • Experienced symptoms for more than twice a week and not on asthma controller
  • If on inhaled steroids (any drug at any dose not exceeding the equivalent of 1000 micrograms (mcg) of fluticasone daily), participant must have been on a stable dose for at least 2 weeks prior to study entry
  • Non-smoker (i.e., total lifetime smoking history less than 10 pack-years; no smoking for at least 1 year prior to study entry)
  • Willing to use an effective form of birth control throughout the study

Inclusion Criteria for BASALT Study:

  • Ability to measure peak expiratory flow (PEF) each morning using the electronic peak flow meter (EPFM) device and to accurately transcribe the PEF measurements onto the diary cards at least 75% of the time during the last 2 weeks of the adherence testing period
  • 75% compliance with recording peak flow measurements and symptoms in a symptom diary during the last 2 weeks of the adherence testing period
  • Ability to take Inhalers A, B, and C at least 75% of scheduled doses; 75% compliance per inhaler is required
  • No treatment failure (includes significant asthma exacerbation) within the last 4 weeks

Exclusion Criteria for BASALT and TALC Studies:

  • Lung disease other than asthma, including chronic obstructive pulmonary disease (COPD) and chronic bronchitis
  • Established or suspected diagnosis of vocal cord dysfunction
  • Significant medical illness other than asthma
  • History of respiratory tract infection within the 4 weeks prior to study entry
  • History of a significant exacerbation of asthma within the 4 weeks prior to study entry
  • History of life-threatening asthma requiring treatment with intubation and mechanical ventilation in the 5 years prior to study entry
  • Hyposensitization therapy other than an established maintenance regimen
  • Inability to coordinate use of the delivery devices used in the study, based on the opinion of the investigator or clinical coordinator
  • Pregnant

Exclusion Criteria for BASALT Study:

  • Inability to coordinate use of the medication delivery devices used in the study, based on the opinion of the investigator or clinical coordinator
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00495157). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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