The classic website will no longer be available as of June 25, 2024. Please use the modernized ClinicalTrials.gov.
Working…
ClinicalTrials.gov
ClinicalTrials.gov Menu

Environmental Control as Add-on Therapy in Childhood Asthma (ECATCh)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT02251379
Recruitment Status : Completed
First Posted : September 29, 2014
Results First Posted : November 4, 2019
Last Update Posted : November 20, 2019
Sponsor:
Information provided by (Responsible Party):
Johns Hopkins University

Tracking Information
First Submitted Date  ICMJE September 22, 2014
First Posted Date  ICMJE September 29, 2014
Results First Submitted Date  ICMJE October 15, 2019
Results First Posted Date  ICMJE November 4, 2019
Last Update Posted Date November 20, 2019
Actual Study Start Date  ICMJE October 1, 2014
Actual Primary Completion Date November 2018   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: October 15, 2019)
The Medication Treatment Step Assigned [ Time Frame: 6 month clinic visit ]
The controller medication treatment step that was assigned at the visit, which is based on the current controller medication treatment step and the current level of asthma control. The range is from 0-6, with 0 indicating no controller medication and 6 indicating high dose inhaled corticosteroids plus long-acting beta agonist.
Original Primary Outcome Measures  ICMJE
 (submitted: September 25, 2014)
The treatment step assigned [ Time Frame: 6 month clinic visit ]
National Asthma Guidelines treatment step
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: October 15, 2019)
  • Daily Inhaled Corticosteroid Dose [ Time Frame: 6 months ]
    micrograms of inhaled corticosteroids (daily)
  • Exhaled Nitric Oxide [ Time Frame: 6 months ]
    Exhaled nitric oxide in parts per billion.
  • Number of Asthma Symptom Days [ Time Frame: 6 months ]
    Number of asthma symptom days in the past two weeks will be a measure of asthma control.
  • Number of Asthma Exacerbations [ Time Frame: 6 months ]
    Asthma exacerbations will be assessed by number of acute visits to the emergency department (ED), hospitalizations and urgent doctor visits.
  • FEV1/FVC [ Time Frame: 6 months ]
    Forced expiratory volume at one second/forced vital capacity (FEV1/FVC) will be evaluated as a continuous variable. This is a ratio without any units.
Original Secondary Outcome Measures  ICMJE
 (submitted: September 25, 2014)
  • Daily inhaled corticosteroid dose [ Time Frame: 6 months ]
    mcg of inhaled corticosteroids (daily)
  • Allergic inflammation markers [ Time Frame: 6 months ]
    specific IgE levels, exhaled nitric oxide
  • Measures of asthma control [ Time Frame: 6 months ]
    asthma control test, symptoms and rescue medication use (Days/last two weeks)
  • Measures of exacerbations [ Time Frame: 6 months ]
    report of ED visits, hospitalizations, steroid bursts in previous 3 months and previous 6 months
  • FEV1/FVC [ Time Frame: 6 months ]
    this will be evaluated as a continuous variable
  • Change in FEV1 after albuterol use [ Time Frame: 6 months ]
    % change in FEV1 after beta agonist use
  • Asthma severity as measured by CASI [ Time Frame: 6 months ]
    Composite Asthma Severity Index Score
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Environmental Control as Add-on Therapy in Childhood Asthma
Official Title  ICMJE Environmental Control as Add-on Therapy in Childhood Asthma
Brief Summary This study evaluates the effects of adding on an environmental home intervention to standard asthma medication management on controller medication requirements among children and adolescents with asthma. The investigators hypothesize that the addition of an individually-tailored, multi-faceted Environmental Control Strategy (ECS) to guidelines-based controller medication will result in less controller medication requirement and allergic inflammation than controller medication alone among urban asthmatic children.
Detailed Description The study is a parallel arm study of an individually tailored, multi-faceted ECS plus controller medication titration versus controller medication titration alone. After a 4-week run-in period to stabilize the asthma, the investigators will randomize 200 Baltimore children with persistent asthma and a recent exacerbation in a 1:1 ratio to the two arms and follow the children for six months. There will be five clinic visits and three home visits over this time period for clinical and home assessments, respectively. There will be up to four environmental intervention visits for participants randomized to the environmental control plus controller medication group. The environmental modules include mouse, cockroach, furry pets, dust mites, and smoking. Air purifiers and laundered bedding are also included in this arm. Participants randomized to the controller medication group have the option of having one home visit after completing the study at which the participants will receive home intervention services that the environmental control plus controller medication group received. Participants will have repeated assessment of: controller medication requirements; secondary clinical, physiologic, and inflammatory outcomes; and particulate matter (PM), air nicotine, and allergen levels.
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Asthma
Intervention  ICMJE
  • Drug: Flovent Diskus
    Inhaled corticosteroids
    Other Name: Flovent Diskus, 50 mcg, 100mcg, 250 mcg
  • Other: Home Environmental Intervention
    Mouse, Cockroach, Furry pets, Dust mites, Smoking, air purifiers, laundered bedding
  • Drug: Advair Diskus
    inhaled corticosteroids + long-acting beta agonist
Study Arms  ICMJE
  • Experimental: ECS + Medication Group
    The Environmental Control Strategy ("Home Environmental Intervention") plus inhaled corticosteroids or inhaled corticosteroids plus long-acting beta agonist. (Flovent Diskus or Advair diskus)
    Interventions:
    • Drug: Flovent Diskus
    • Other: Home Environmental Intervention
    • Drug: Advair Diskus
  • Active Comparator: Medication Group Alone
    inhaled corticosteroids or inhaled corticosteroids plus long-acting beta agonist. (Flovent Diskus or Advair diskus)
    Interventions:
    • Drug: Flovent Diskus
    • Drug: Advair Diskus
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: December 17, 2018)
155
Original Estimated Enrollment  ICMJE
 (submitted: September 25, 2014)
200
Actual Study Completion Date  ICMJE November 2018
Actual Primary Completion Date November 2018   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Have physician-diagnosed asthma at least 1 year prior to the baseline visit, or asthma symptoms for at least 1 year
  • Meet criteria for current persistent asthma defined as either:

    1. On a long-term controller medication for asthma, or
    2. Meet National Asthma Education and Prevention Program (NAEPP) guideline requirements for persistent disease:(46)
  • Asthma symptoms 3 or more days per week over the past 2 weeks or
  • Nocturnal asthma symptoms at least 3 times in the past month
  • Have evidence of uncontrolled disease as defined by at least one of the following:

    1. One asthma-related unscheduled visit to an emergency department (ED), clinic or urgent care facility in the previous 12 mo
    2. One asthma-related overnight hospitalization in the previous 12 mo
    3. One or more bursts of oral corticosteroids in the previous 12 mo
  • Reside within a geographic area of the study site so that home visits are feasible.
  • Have no plans to move within the upcoming 6 months
  • Have insurance to cover prescription medications.
  • Have a positive skin test (net wheal ≥2mm) to cat, dog, mouse, cockroach, or dust mites or have a positive cat, dog, mouse, German cockroach, or D. farinae-specific immunoglobulin E (IgE) test, as quantified using the ImmunoCAP system (≥0.35 kU/L)

Exclusion Criteria:

  • Lung disease, other than asthma, that requires daily medication
  • Cardiovascular disease that requires daily medication, excluding hypertension
  • Taking a beta-blocker
  • Allergy to dairy
  • On Xolair < 5 months
  • On immunotherapy and has not reached maintenance dose
  • Sleeping in another home 4 or more nights/week
  • Active smoker defined as a positive urine screen for high levels of urine cotinine
  • Unable to access areas of home necessary to conduct extermination
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 5 Years to 17 Years   (Child)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT02251379
Other Study ID Numbers  ICMJE NA_00093323
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE Not Provided
Current Responsible Party Johns Hopkins University
Original Responsible Party Elizabeth Matsui, Johns Hopkins University, Associate Professor of Pediatrics, Epidemiology, and Environmental Health Sciences
Current Study Sponsor  ICMJE Johns Hopkins University
Original Study Sponsor  ICMJE Same as current
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Study Chair: Elizabeth C Matsui, MD MHS Johns Hopkins University
Principal Investigator: Meredith McCormack, MD MHS Johns Hopkins University
Principal Investigator: Corinne Keet, MD PHD Johns Hopkins University
PRS Account Johns Hopkins University
Verification Date November 2019

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP