The American Academy of Family Physicians (AAFP), in partnership with Penn State College of Medicine, has been approved for a $31 million funding award by the Patient-Centered Outcomes Research Institute (PCORI) to study the comparative effectiveness of asthma treatments. The project will focus on which of two treatment types – inhaled steroids or specific antibiotics, alone or together – works best in different patients.
Asthma is a common chronic disease affecting more than 20 million Americans, and asthma exacerbations are the leading cause of missed school or work for children and young adults, according to the Centers for Disease Control and Prevention (CDC). Population surveys by the CDC indicate that despite ongoing advances in asthma therapies, exacerbation rates have dropped only marginally in the past 20 years.
Nearly all family physicians encounter patients with asthma, and we know that some patient groups face higher rates of death and high rates of severe complications. By further understanding which types of treatments are more or less effective for different patient, we can treat patients with asthma more effectively and help improve their quality of life."
Julie Wood, MD, MPH, FAAFP, senior vice president of Research, Science and Health of the Public for the AAFP
The Individualizing Treatment for Asthma in Primary Care (iTREAT-PC) study will test the interventions both alone and together in more than 3,000 people with asthma aged 12 and over. People will be followed for 16 months to determine which therapy is most effective in which individuals. The research will be conducted at 10 health care systems and research networks across the country that are part of the AAFP National Research Network (NRN).
Wilson Pace, MD, of the AAFP NRN, will serve as the co-investigator and clinical lead for the project.
"This will be the first study to compare the use of these two particular therapies – the antibiotic azithromycin to treat a broad spectrum of individuals with asthma and the use of inhaled corticosteroids as part of rescue therapy," said Pace. "I have been involved in other large asthma studies, but this is the first to determine if anecdotal reports of asthma 'cures' from long term antibiotic use can be substantiated."
The study builds on the success of the recent PREPARE study. The Person Empowered Asthma Relief (PREPARE) trial, also funded by PCORI, found that patient-activated reliever-triggered inhaled glucocorticoid (PARTICS) strategy, plus continuing usual care and medications, lessened asthma symptoms and improved quality of life in Black and Latinx adults with moderate-to-severe asthma.
PCORI is a nonprofit organization that funds research to provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions.
The iTREAT-PC study award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.