Biomarkers for Inhaled Corticosteroids in Severe Asthma

  • Research type

    Research Study

  • Full title

    Biomarkers for Predicting Response and Monitoring Adherence to Inhaled Corticosteroids in Severe Asthma\n

  • IRAS ID

    229380

  • Contact name

    Stephen Fowler

  • Contact email

    stephen.fowler@manchester.ac.uk

  • Sponsor organisation

    Manchester University NHS Foundation Trust

  • Duration of Study in the UK

    0 years, 10 months, 0 days

  • Research summary

    The first line therapy for managing asthma is Inhaled CorticoSteroids (ICSs), which help provide long-term disease control by reducing or suppressing airway inflammation. For a number of reason (including forgetfulness, cost, concerns about side effects) adherence to inhaler treatment is very low, with only around 20-30% of people with asthma taking the full prescribed amount. The need for quick and non-invasive procedures that determine adherence and assess the early response to ICS is necessary. The aims of this study are to investigate novel methods: 1. to measure adherence in asthma (by detecting ICS in blood and breath samples); and 2. to identify an early response to ICS using tests of airway inflammation in the breath [Fractional Exhaled Nitric Oxide (FeNO), breath gas Volatile Organic Compounds (VOCs), Particles in of Exhaled Air (PExA), and Breath Exhaled Temperature (EBT)]. Potential participants will be recruited from those due to attend for a clinical test (called a FENO Suppression Test).\n\nAfter the initial assessment, patients will perform baseline measurements which include: FeNO, EBT, VOCs, PExA, Asthma Control Questionnaire (ACQ), spirometry and blood sample. After the initial evaluation, the patients will undergo the FENO suppression test (NB not a research procedure), for which they will initially take 500 µg inhaled fluticasone propionate (Flixotide Accuhaler) attached to an electronic device called Inhaler Compliance Assessment (INCA). Further measurements of FeNO, EBT, PEXA, and VOC will be taken at 30, 60 and 120 minutes post ICS inhaler. Patients will be sent home with Flixotide® 1000 mcg Accuhaler/INCA (to be taken two puffs in the morning) for seven days (again, part of the FENO suppression test). After that, patients will return to the hospital at day seven for clinical assessment (FENO suppression test), and patient will repeat the research measurements (FeNO, EBT, VOCs, PExA, ACQ, blood and spirometry). \n

  • REC name

    South West - Cornwall & Plymouth Research Ethics Committee

  • REC reference

    18/SW/0058

  • Date of REC Opinion

    1 Mar 2018

  • REC opinion

    Further Information Favourable Opinion