Doctors working to pinpoint better drugs for fighting asthma

ST. LOUIS -- St. Louis researchers have launched a clinical trial to pinpoint the best first treatment for children with mild to moderate asthma, hoping to find more effective ways to combat the chronic lung disease.

While nationwide the number of children with asthma has more than doubled over the past decade, prevalence rates in children in some parts of the St. Louis area have soared two to three times above the national rate of 6 percent.

Still, fewer than one-third of asthma medications on the market have been approved for use in children.

The clinical trial is being conducted through the Childhood Asthma Research and Education Network, based at the Washington University Clinical Research Center at St. Louis Children's Hospital. The network is among five of its kind across the country funded by the National Institutes of Health.

Researchers will compare medications Advair, Singulair and Flovent as part of the year-long clinical trial to study the medications in 60 children ages 6 to 13.

The trial is a randomized, double-blind study, meaning no one will know until it's over who's getting which medication.

Comparing medication

"Because drug companies don't like to do head-to-head comparisons of their medications with those of their competitors, networks like ours do them," principal investigator Dr. Robert C. Strunk, a professor of pediatrics at Washington University School of Medicine, told the St. Louis Post-Dispatch.

Asthma is caused by inflammation of the small airways in the lungs.

When the airways become swollen and congested with mucous, muscle spasms around the airways block the normal flow of air, causing coughing, wheezing, chest tightness and difficulty breathing.

The condition can be life-threatening if not treated appropriately.

A complex interplay of moist climate, air pollution, smoking rates, older housing stock and other factors contributes to the St. Louis region's higher asthma prevalence.

Allergies, mold, pollen, pet dander, dust mites, cold winter air, leaf burning and upper respiratory infections commonly trigger asthma attacks.

Repeated attacks can led to permanent scarring of the lungs.

"Asthma occurs across all socioeconomic levels, but lower-income children tend to have a higher rate," said Tina Barnard, director of the southwest region of the American Lung Association of Illinois and Iowa.

A study published last year showed that children living in ZIP codes in St. Louis where the household income was $20,000 or less had asthma rates eight times higher than those in more affluent areas in west St. Louis County, asthma expert Dr. Mario Castro said.

Studying who is at risk

The risk is three times greater if you live in a ZIP code that is largely black, said Castro, chairman of the St. Louis Regional Asthma Consortium established about three years ago to get information and resources to people with asthma.

For more information about the study, call (314) 286-1173 or toll-free at (866) 841-2273.