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Childhood Asthma Management Program (CAMP) Phases I (Trial), II (CAMPCS), III (CAMPCS/2), and IV (CAMPCS/3)
This study is enrolling participants by invitation only.
First Received: October 27, 1999   Last Updated: February 13, 2009   History of Changes
Sponsored by: National Heart, Lung, and Blood Institute (NHLBI)
Information provided by: National Heart, Lung, and Blood Institute (NHLBI)
ClinicalTrials.gov Identifier: NCT00000575
  Purpose

The purpose of this study is to evaluate the long term effects of anti-inflammatory therapy compared to bronchodilator therapy on the course of asthma, particularly on lung function and bronchial hyperresponsiveness, and on physical and psychosocial growth and development.


Condition Intervention Phase
Asthma
Lung Diseases
Drug: Placebo
Drug: Nedocromil
Drug: Budesonide
Phase III

MedlinePlus related topics: Asthma
Drug Information available for: Budesonide Nedocromil Nedocromil sodium Nedocromil calcium
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator), Placebo Control, Parallel Assignment, Safety/Efficacy Study
Official Title: Childhood Asthma Management Program

Further study details as provided by National Heart, Lung, and Blood Institute (NHLBI):

Primary Outcome Measures:
  • To determine the long-term effects of 3 treatments (either of two classes of anti-inflammatory agents [budesonide or nedocromil] and placebo) on pulmonary function as measured by normalized FEV1 over a 5-6.5 year period in children with asthma [ Time Frame: Measured every 4 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • To determine if the three treatments differ with respect to the long-term effects on bronchial responsiveness to methacholine [ Time Frame: Measured once per year ] [ Designated as safety issue: No ]
  • Difference between the three treatments with respect to morbidity; measured by PEFR, frequency & severity of asthma symptoms, days of limited activity, nocturnal awakenings, use of albuterol & prednisone to control symptoms, and pulmonary function [ Time Frame: Measured through the use of daily patient diaries ] [ Designated as safety issue: No ]
  • To determine if the three treatments differ with respect to use of health care resources such as emergency room visits, hospitalizations, and physician contacts [ Time Frame: Measured every 4 months ] [ Designated as safety issue: No ]
  • To determine if the three treatments differ with respect to mortality, long-term safety, and side effects [ Time Frame: Measured every 4 months ] [ Designated as safety issue: Yes ]
  • To determine if the three treatments differ with respect to physical growth and development as indicated by sexual maturation, growth rates, and bone density [ Time Frame: Sexual maturation & bone density measured annually; growth rates measured every 4 months ] [ Designated as safety issue: No ]
  • To determine if the three treatments differ with respect to psychological growth and development as indicated by measures of neurocognitive functioning and psychological adjustment [ Time Frame: Measured at baseline and Years 3 and 5 ] [ Designated as safety issue: No ]
  • To determine the influence of environmental and psychological factors and atopic status in response to the different treatments [ Time Frame: Environmental questionnaire used to measure annually; skin testing at baseline and Year 5 ] [ Designated as safety issue: No ]

Enrollment: 1041
Study Start Date: September 1991
Estimated Study Completion Date: June 2011
Primary Completion Date: October 1999 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1 Budesonide: Active Comparator
Budesonide (Pulmicort), two 100 Og puffs bid + two Og puffs albuterol (Ventolin) prn
Drug: Budesonide
Two 100 Og puffs bid + two 90 Og puffs albuterol prn.
2 Nedocromil: Active Comparator
Nedocromil (Tilade), four 2 mg puffs bid + two 90 Og puffs albuterol prn
Drug: Nedocromil
Four 2 mg puffs bid + two 90 Og puffs albuterol prn
3 Placebo: Placebo Comparator
Two 100 Og puffs budesonide placebo bid + two 90 Og puffs albuterol prn or four 2 mg puffs nedocromil placebo bid + two 90 Og puffs albuterol prn.
Drug: Placebo
Two 100 Og puffs budesonide placebo bid + two 90 Og puffs albuterol prn OR four 2 mg puffs nedocromil placebo bid + two 90 Og puffs albuterol prn.

  Show Detailed Description

  Eligibility

Ages Eligible for Study:   5 Years to 12 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion criteria:

  • Age 5 to 12 years at time of screening
  • Chronic asthma as evidenced by one or more of the following historical findings for at least 6 months during the past year:
  • Asthma symptoms at least 2 times per week
  • 2 or more usages per week of an inhaled bronchodilator
  • Daily asthma medication
  • Current asthma symptoms either by diary symptom code of 1 or greater or am or pm PEFR less than 80% of personal best post-bronchodilator value by diary, on 8 or more days during the prn screening period
  • Methacholine sensitivity: estimated PC20 FEV1 less than or equal to 12.5 mg/ml
  • Consent of guardian and assent of child
  • Ability to comply with trial for 5 - 6.5 years

Exclusion criteria:

  • Presence of one or more of the following confounding or complicating problems:
  • Any other active pulmonary disease
  • Any chronic condition presumed to interfere with the successful completion of the project or confound its interpretation
  • Pulmonary function testing findings suggesting a ventilatory defect other than asthma, or evidence of existing irreversible lung damage
  • Severe chronic sinusitis or nasal polyposis
  • Introduction of or a change in allergen immunotherapy within the past month
  • Use of more than 4 sprays of nasal steroids daily (only beclomethasone allowed)
  • Pregnancy
  • Current use of metoclopramide, ranitidine, or cimetidine
  • Treatment for gastroesophageal reflux
  • Participation in another drug study
  • Evidence of severe asthma as indicated by one or more of the following:
  • Two or more hospitalizations for asthma in the past year
  • Six or more steroid bursts in the past year
  • Demonstrated need for continuous use of glucocorticoids, either oral or inhaled
  • When off inhaled O2-agonist for more than 4 hrs and theophylline for more than 24 hrs, FEV1 less than 65% predicted
  • Intubation for asthma at any time in the past
  • Need for 9 or more puffs/day of albuterol for each of 3 consecutive days (excluding preventive use prior to exercise), or nocturnal asthma awakenings more than 1.5 times per week on average, or average diary card symptom code greater than 2, or requirement for other medications to control asthma, during prn screening period
  • Inability to perform 3 acceptable FVC maneuvers of which at least 2 reproducible FEV1s are within 10% of the largest FEV1
  • Inability to complete the methacholine challenge or methacholine PC20 FEV1 greater than 12.5 mg/ml
  • Evidence that patient or family may be unreliable or non-compliant or may move from the metropolitan area before trial completion
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00000575

Sponsors and Collaborators
Investigators
Principal Investigator: N. F. Adkinson, MD Johns Hopkins University
Principal Investigator: Anne Fuhlbrigge, MD, MS Brigham and Women's Hospital
Principal Investigator: H. W. Kelly, PharmD University of New Mexico
Principal Investigator: Padmaja Subbarao, MD, MSc The Hospital for Sick Children
Principal Investigator: Paul Williams, MD Asthma, Inc.
Principal Investigator: Robert Strunk, MD Washington University School of Medicine
Principal Investigator: Stanley Szefler, MD National Jewish Health
Principal Investigator: James Tonascia, PhD Johns Hopkins University
Principal Investigator: Robert Zeiger, MD, PhD University of California, San Diego
  More Information

Publications:
[No authors listed] Design and implementation of a patient education center for the Childhood Asthma Management Program. Childhood Asthma Management Program Research Group. Ann Allergy Asthma Immunol. 1998 Dec;81(6):571-81.
[No authors listed] Recruitment of participants in the childhood Asthma Management Program (CAMP). I. Description of methods: Childhood Asthma Management Program Research Group. J Asthma. 1999 May;36(3):217-37.
[No authors listed] The Childhood Asthma Management Program (CAMP): design, rationale, and methods. Childhood Asthma Management Program Research Group. Control Clin Trials. 1999 Feb;20(1):91-120.
Zeiger RS, Dawson C, Weiss S. Relationships between duration of asthma and asthma severity among children in the Childhood Asthma Management Program (CAMP) J Allergy Clin Immunol. 1999 Mar;103(3 Pt 1):376-87.
Nelson HS, Szefler SJ, Jacobs J, Huss K, Shapiro G, Sternberg AL. The relationships among environmental allergen sensitization, allergen exposure, pulmonary function, and bronchial hyperresponsiveness in the Childhood Asthma Management Program. J Allergy Clin Immunol. 1999 Oct;104(4 Pt 1):775-85.
Bender BG, Annett RD, Ikle D, DuHamel TR, Rand C, Strunk RC. Relationship between disease and psychological adaptation in children in the Childhood Asthma Management Program and their families. CAMP Research Group. Arch Pediatr Adolesc Med. 2000 Jul;154(7):706-13.
Larsen GL. Focusing on childhood asthma: the childhood asthma management program (CAMP) J Allergy Clin Immunol. 1999 Mar;103(3 Pt 1):371-3. No abstract available.
Weiss ST, Van Natta ML, Zeiger RS. Relationship between increased airway responsiveness and asthma severity in the childhood asthma management program. Am J Respir Crit Care Med. 2000 Jul;162(1):50-6.
Annett RD, Aylward EH, Lapidus J, Bender BG, DuHamel T. Neurocognitive functioning in children with mild and moderate asthma in the childhood asthma management program. The Childhood Asthma Management Program (CAMP) Research Group. J Allergy Clin Immunol. 2000 Apr;105(4):717-24.
[No authors listed] Long-term effects of budesonide or nedocromil in children with asthma. The Childhood Asthma Management Program Research Group. N Engl J Med. 2000 Oct 12;343(15):1054-63.
Huss K, Adkinson NF Jr, Eggleston PA, Dawson C, Van Natta ML, Hamilton RG. House dust mite and cockroach exposure are strong risk factors for positive allergy skin test responses in the Childhood Asthma Management Program. J Allergy Clin Immunol. 2001 Jan;107(1):48-54.
Yu O, Sheppard L, Lumley T, Koenig JQ, Shapiro GG. Effects of ambient air pollution on symptoms of asthma in Seattle-area children enrolled in the CAMP study. Environ Health Perspect. 2000 Dec;108(12):1209-14.
Annett RD, Bender BG, Lapidus J, Duhamel TR, Lincoln A. Predicting children's quality of life in an asthma clinical trial: what do children's reports tell us? J Pediatr. 2001 Dec;139(6):854-61.
Weiss ST, Horner A, Shapiro G, Sternberg AL. The prevalence of environmental exposure to perceived asthma triggers in children with mild-to-moderate asthma: data from the Childhood Asthma Management Program (CAMP). J Allergy Clin Immunol. 2001 Apr;107(4):634-40.
Strunk RC, Sternberg AL, Bacharier LB, Szefler SJ. Nocturnal awakening caused by asthma in children with mild-to-moderate asthma in the childhood asthma management program. J Allergy Clin Immunol. 2002 Sep;110(3):395-403.
DeMeo DL, Lange C, Silverman EK, Senter JM, Drazen JM, Barth MJ, Laird N, Weiss ST. Univariate and multivariate family-based association analysis of the IL-13 ARG130GLN polymorphism in the Childhood Asthma Management program. Genet Epidemiol. 2002 Nov;23(4):335-48.
Strunk RC, Bender B, Young DA, Sagel S, Glynn E, Caesar M, Lawhon C. Predictors of protocol adherence in a pediatric asthma clinical trial. J Allergy Clin Immunol. 2002 Oct;110(4):596-602.
Kelly HW, Strunk RC, Donithan M, Bloomberg GR, McWilliams BC, Szefler S. Growth and bone density in children with mild-moderate asthma: a cross-sectional study in children entering the Childhood Asthma Management Program (CAMP). J Pediatr. 2003 Mar;142(3):286-91.
Bacharier LB, Dawson C, Bloomberg GR, Bender B, Wilson L, Strunk RC; Childhood Asthma Management Program Research Group. Hospitalization for asthma: atopic, pulmonary function, and psychological correlates among participants in the Childhood Asthma Management Program. Pediatrics. 2003 Aug;112(2):e85-92.
Tantisira KG, Litonjua AA, Weiss ST, Fuhlbrigge AL; Childhood Asthma Management Program Research Group. Association of body mass with pulmonary function in the Childhood Asthma Management Program (CAMP). Thorax. 2003 Dec;58(12):1036-41.
Silverman EK, Kwiatkowski DJ, Sylvia JS, Lazarus R, Drazen JM, Lange C, Laird NM, Weiss ST. Family-based association analysis of beta2-adrenergic receptor polymorphisms in the childhood asthma management program. J Allergy Clin Immunol. 2003 Nov;112(5):870-6.
Lange C, Lyon H, DeMeo D, Raby B, Silverman EK, Weiss ST. A new powerful non-parametric two-stage approach for testing multiple phenotypes in family-based association studies. Hum Hered. 2003;56(1-3):10-7.
Slaughter JC, Lumley T, Sheppard L, Koenig JQ, Shapiro GG. Effects of ambient air pollution on symptom severity and medication use in children with asthma. Ann Allergy Asthma Immunol. 2003 Oct;91(4):346-53.
Bender BG, Ellison MC, Gleason M, Murphy JR, Sundstrom DA, Szefler SJ. Minimizing attrition in a long-term clinical trial of pediatric asthma. Ann Allergy Asthma Immunol. 2003 Aug;91(2):168-76.
Raby BA, Silverman EK, Lazarus R, Lange C, Kwiatkowski DJ, Weiss ST. Chromosome 12q harbors multiple genetic loci related to asthma and asthma-related phenotypes. Hum Mol Genet. 2003 Aug 15;12(16):1973-9.
Lake SL, Lyon H, Tantisira K, Silverman EK, Weiss ST, Laird NM, Schaid DJ. Estimation and tests of haplotype-environment interaction when linkage phase is ambiguous. Hum Hered. 2003;55(1):56-65.
Bacharier LB, Raissy HH, Wilson L, McWilliams B, Strunk RC, Kelly HW. Long-term effect of budesonide on hypothalamic-pituitary-adrenal axis function in children with mild to moderate asthma. Pediatrics. 2004 Jun;113(6):1693-9.
Covar RA, Spahn JD, Murphy JR, Szefler SJ. Progression of Asthma Measured by Lung Function in the Childhood Asthma Management Program. Am J Respir Crit Care Med. 2004 Mar 17 [Epub ahead of print]
Tantisira KG, Lake S, Silverman ES, Palmer LJ, Lazarus R, Silverman EK, Liggett SB, Gelfand EW, Rosenwasser LJ, Richter B, Israel E, Wechsler M, Gabriel S, Altshuler D, Lander E, Drazen J, Weiss ST. Corticosteroid pharmacogenetics: association of sequence variants in CRHR1 with improved lung function in asthmatics treated with inhaled corticosteroids. Hum Mol Genet. 2004 Jul 1;13(13):1353-9. Epub 2004 May 05.
Lazarus R, Raby BA, Lange C, Silverman EK, Kwiatkowski DJ, Vercelli D, Klimecki WJ, Martinez FD, Weiss ST. Toll-like Receptor 10 (TLR10) Genetic Variation is Associated with Asthma in Two Independent Samples. Am J Respir Crit Care Med. 2004 Jun 16 [Epub ahead of print]
Covar RA, Szefler SJ, Martin RJ, Sundstrom DA, Silkoff PE, Murphy J, Young DA, Spahn JD. Relations between exhaled nitric oxide and measures of disease activity among children with mild-to-moderate asthma. J Pediatr. 2003 May;142(5):469-75.
Covar RA, Spahn JD, Martin RJ, Silkoff PE, Sundstrom DA, Murphy J, Szefler SJ. Safety and application of induced sputum analysis in childhood asthma. J Allergy Clin Immunol. 2004 Sep;114(3):575-82.
Randolph AG, Lange C, Silverman EK, Lazarus R, Silverman ES, Raby B, Brown A, Ozonoff A, Richter B, Weiss ST. The IL12B gene is associated with asthma. Am J Hum Genet. 2004 Oct;75(4):709-15. Epub 2004 Aug 20.
Randolph AG, Lange C, Silverman EK, Lazarus R, Weiss ST. Extended Haplotype in the Tumor Necrosis Factor Gene Cluster Is Associated with Asthma and Asthma-related Phenotypes. Am J Respir Crit Care Med. 2005 Sep 15;172(6):687-92. Epub 2005 Jun 23.
Annett RD, Stansbury K, Kelly HW, Strunk RC. Association of hypothalamic-pituitary-adrenal axis function with neuropsychological performance in children with mild/moderate asthma. Neuropsychol Dev Cogn C Child Neuropsychol. 2005 Aug;11(4):333-48.
Raby BA, Hwang ES, Steen KV, Tantisira K, Peng S, Litonjua A, Lazarus R, Giallourakis C, Rioux JD, Sparrow D, Silverman EK, Glimcher LH, Weiss ST. T-bet polymorphisms are associated with asthma and airway hyperresponsiveness. Am J Respir Crit Care Med. 2006 Jan 1;173(1):64-70. Epub 2005 Sep 22.
Raby BA, Van Steen K, Celedon JC, Litonjua AA, Lange C, Weiss ST. Paternal history of asthma and airway responsiveness in children with asthma. Am J Respir Crit Care Med. 2005 Sep 1;172(5):552-8. Epub 2005 Jun 3.

Responsible Party: NHLBI ( Virginia Taggart, Project Officer )
Study ID Numbers: 213
Study First Received: October 27, 1999
Last Updated: February 13, 2009
ClinicalTrials.gov Identifier: NCT00000575     History of Changes
Health Authority: United States: Federal Government

Study placed in the following topic categories:
Anti-Inflammatory Agents
Bronchial Diseases
Hormone Antagonists
Albuterol
Hormones, Hormone Substitutes, and Hormone Antagonists
Budesonide
Anti-Asthmatic Agents
Asthma
Anti-Allergic Agents
Hormones
Glucocorticoids
Lung Diseases, Obstructive
Hypersensitivity
Respiratory Tract Diseases
Lung Diseases
Hypersensitivity, Immediate
Peripheral Nervous System Agents
Nedocromil
Bronchodilator Agents
Respiratory Hypersensitivity

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Respiratory System Agents
Bronchial Diseases
Immune System Diseases
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Budesonide
Anti-Asthmatic Agents
Asthma
Anti-Allergic Agents
Hormones
Glucocorticoids
Pharmacologic Actions
Lung Diseases, Obstructive
Hypersensitivity
Respiratory Tract Diseases
Autonomic Agents
Therapeutic Uses
Lung Diseases
Hypersensitivity, Immediate
Peripheral Nervous System Agents
Nedocromil
Bronchodilator Agents
Respiratory Hypersensitivity

ClinicalTrials.gov processed this record on May 07, 2009