| Autor: |
Jonathan Grigg, Roger Tavendale, Helen Smith, Somnath Mukhopadhyay, Roberta Littleford, Kristina Pilvinyte, Colin N. A. Palmer, Fiona Hogarth, Christina J Jones, Steve Turner, Thomas Ruffles, Brian J. Lipworth, Petra Rauchhaus |
| Rok vydání: |
2020 |
| Předmět: |
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| Zdroj: |
Paediatric asthma and allergy. |
| Popis: |
Introduction: The A allele of rs1042713 (Arg16 amino acid) is associated with poor response to long-acting β2 agonist (LABA) in young people with asthma. We aimed to evaluate whether prescribing asthma controller medication according to rs1042713 genotype would result in improvement in asthma quality of life (AQLQ). Methods: Randomized controlled trial with participants recruited from the UK via primary care research networks. Participants aged 12-18 years with asthma taking inhaled corticosteroid were randomly assigned (1:1) to receive personalized care (rs1042713 genotype based prescribing) or standard care (BTS guidelines). Participants were followed-up for 12 months. The primary outcome measure was change in AQLQ. Asthma control, exacerbation frequency and healthcare utilization were secondary outcomes. Results: 241 participants were randomized to personalized (n=121) or standard care (n=120). Provision of asthma controller medication based on rs1042713 genotype resulted in a significant improvement in AQLQ compared to standard care (0·16, 95%CI 0·00-0·31; p=0·049) the difference was below clinical threshold (0·25). Those with A/A genotype showed the greatest improvement in AQLQ when personalized care was compared to standard (0·42, 95%CI 0·02-0.81; p=0·041). Conclusion: PACT is the first study to demonstrate that genotype-based asthma controller prescribing results in a significant improvement in a primary clinical outcome compared to standard care. Those homozygous for Arg16 (A/A) benefitted most. The potential role of rs1042713 genotype directed therapy in younger and more severe children’s asthma requires further exploration. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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