As Asthma Rates Rise, Researchers Examine Medicines for Kids

December 07, 2012
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As asthma rates continue to rise in the U.S. — proportionally affecting more children than adults — experts at UCSF and across the nation continue to search for the best medicines for pediatric patients.

Nearly 10 percent of American children under the age of 17 were diagnosed with the condition between 2008 and 2010. In many cases, the condition requires emergency care.

Michael Cabana

Michael D. Cabana, M.D.

To hone effective treatments, two related studies that include researchers from UCSF are underway to closely examine the effectiveness of pediatric asthma medicines. The studies are called APRIL, for Azithromycin for Preventing the development of upper Respiratory tract Illness into Lower respiratory tract symptoms, and OCELOT for Oral Corticosteroids for treating Episodes of significant LOwer respiratory Tract symptoms in children.

"We have many medications and therapies for asthma, but we need to better understand which medications are first-line for specific situations and for specific kids," said Dr. Michael D. Cabana, chief of General Pediatrics at UCSF Benioff Children's Hospital, who is leading UCSF's efforts for the multi-site research.

The APRIL/OCELOT dovetailed studies, which follow 600 preschool-age children with recurring wheezing, are investigating the antibiotic azithromycin to see if it can prevent asthma attacks and reduce the need for emergency care, essentially limiting the condition's severity.

Prior research has shown that this class of antibiotics can reduce inflammation and is potentially useful for treating early asthma in adults. However, it is not yet known if these medications are effective in children.

Researchers are also looking into systematic corticosteroids to better understand how much of a difference they make after an asthma attack has begun. The steroid is known to stop attacks, but affects the entire body and can be associated with side effects for some children.

The APRIL/OCELOT studies are part of AsthmaNet, a clinical trial collaboration funded by the National Institutes of Health (NIH) that involves nine sites, including UCSF.

"AsthmaNet also tackles those questions that pharmaceutical companies might be reluctant to ask," said Cabana. "For example, can we safely treat children with asthma with less medication or safely avoid giving a specific medication?"

The UCSF research team, which is working in partnership with Children's Hospital and Research Center Oakland, is being assisted by the Clinical Research Services (CRS) program of UCSF's Clinical and Translational Science Institute (CTSI). In particular, the CRS Pediatric Clinical Research Center, one of eight Bay Area clinical sites managed by CTSI, is providing hospital space for patient exams and assessments as well as helping with study coordination.

"CTSI helps us provide the best clinical care including state-of-the-art equipment and technical expertise necessary to conduct our careful assessments," Cabana said. "CTSI has also helped us to reach out to many neighborhoods in the Bay Area to be able to include children from diverse backgrounds, making sure that what we learn is generalizable to the broader population."

UCSF's CTSI is a member of the Clinical and Translational Science Awards network funded through the National Center for Advancing Translational Sciences (grant Number UL1 TR000004) at the National Institutes of Health (NIH). Under the banner of "Accelerating Research to Improve Health," CTSI provides a wide range of resources and services for researchers, and promotes online collaboration and networking tools such as UCSF Profiles.

About UCSF Benioff Children's Hospital
UCSF Benioff Children's Hospital creates an environment where children and their families find compassionate care at the forefront of scientific discovery, with more than 150 experts in 50 medical specialties serving patients throughout Northern California and beyond. The hospital admits about 5,000 children each year, including 2,000 babies born in the hospital. For more information, visit

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