The Journal of Allergy and Clinical Immunology
Volume 122, Issue 5 , Pages 921-928.e4 , November 2008

Clinical predictors and outcomes of consistent bronchodilator response in the childhood asthma management program

  • Sunita Sharma, MD

      Affiliations

    • Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass
    • Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Mass
    • Center for Genomic Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
    • Corresponding Author InformationReprint requests: Sunita Sharma, MD, Channing Laboratory, 181 Longwood Ave, Boston, MA 02115.
    • ,
  • Augusto A. Litonjua, MD

      Affiliations

    • Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass
    • Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Mass
    • Center for Genomic Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
    • ,
  • Kelan G. Tantisira, MD

      Affiliations

    • Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass
    • Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Mass
    • Center for Genomic Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
    • ,
  • Anne L. Fuhlbrigge, MD

      Affiliations

    • Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass
    • Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Mass
    • Center for Genomic Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
    • ,
  • Stanley J. Szefler, MD

      Affiliations

    • Divisions of Pediatric Clinical Pharmacology, Allergy, and Immunology, Department of Pediatrics, National Jewish Medical and Research Center, Denver, Colo
    • ,
  • Robert C. Strunk, MD

      Affiliations

    • Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo
    • ,
  • Robert S. Zeiger, MD, PhD

      Affiliations

    • Department of Allergy, Kaiser Permanente Medical Center, San Diego, Calif
    • ,
  • Amy J. Murphy, PhD

      Affiliations

    • Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass
    • Center for Genomic Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
    • ,
  • Scott T. Weiss, MD, MS

      Affiliations

    • Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass
    • Center for Genomic Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
    • ,
  • Childhood Asthma Management Program Research Group

      Affiliations

    • The members of the research group are listed at the end of the article.

Received 20 February 2008 ,Revised 22 July 2008 ,Accepted 3 September 2008.

  • Image Result

    Distribution of baseline BDRs in the CAMP study. The histogram demonstrates the distribution of BDRs at randomization of the 1041 children participating in the CAMP.

    Distribution of baseline BDRs in the CAMP study. The histogram demonstrates the distribution of BDRs at randomization of the 1041 children participating in the CAMP.

  • Image Result

    Number of subjects with BDRs at each yearly follow-up visit. The graph demonstrates the number of subjects who had a positive BDR at each yearly follow-up visit. Nonresponders (solid columns) had less

    Number of subjects with BDRs at each yearly follow-up visit. The graph demonstrates the number of subjects who had a positive BDR at each yearly follow-up visit. Nonresponders (solid columns) had less than a 12% and 200-mL improvement in FEV1 values after inhaled bronchodilator administration. Responders (open columns) had a BDR if improvement was greater than 12% and 200 mL.

  • Image Result
    Mean BDRs at yearly visits in responders and nonresponders. The graph shows the mean BDR as the percentage change in FEV1 in consistent responders (solid line) versus nonresponders (dashed line) at ea

    Mean BDRs at yearly visits in responders and nonresponders. The graph shows the mean BDR as the percentage change in FEV1 in consistent responders (solid line) versus nonresponders (dashed line) at each of the yearly follow-up visits in the trial.

 The Childhood Asthma Management Program is supported by contracts NO1-HR-16044, 16045, 16046, 16047, 16048, 16049, 16050, 16051, and 16052 with the National Heart, Lung, and Blood Institute and General Clinical Research Center grants M01RR00051, M01RR0099718-24, M01RR02719-14, and RR00036 from the National Center for Research Resources. Additional support for this study was provided by grants U01 HL075419, U01 HL65899, P01 HL083069, and T32 HL07427 from the National Heart, Lung, and Blood Institute, National Institutes of Health.

 Disclosure of potential conflict of interest: A. L. Fuhlbrigge has served on the speakers' bureau and respiratory specialist advisory panel for GlaxoSmithKline and Merck, has received funding from Novartis and Sepracor, and has received research grants from Boehringer Ingelheim, GlaxoSmithKline, and Merck. S. J. Szefler has served as a consultant for AstraZeneca, GlaxoSmithKline, Aventis, Genentech, and Merck and has received research grants from the National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI); the Childhood Asthma Management Program; NHLBI Childhood Asthma Research and Education; the NIH/NHLBI Asthma Clinical Research Network; the NIH/National Institute of Allergy and Infectious Diseases Inner-City Asthma Consortium; and Ross Pharmaceuticals. R. S. Zeiger has served as a consultant for AstraZeneca, Aerocrine, Merck, Schering-Plough, Genentech, Dynavac, and GlaxoSmithKline and has received research grant from Sanofi-Aventis, GlaxoSmithKline, Genentech and the NHLBI. S. T. Weiss has received research support from the NIH and Genentech. The rest of the authors have declared that they have no conflict of interest.

PII: S0091-6749(08)01562-5

doi: 10.1016/j.jaci.2008.09.004

The Journal of Allergy and Clinical Immunology
Volume 122, Issue 5 , Pages 921-928.e4 , November 2008

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