If an add-on controller is required, young people in this arm will be prescribed personalised medicine by results of the genotyping for the adrenergic beta2-receptor gene (ADRB2). Health professional's will be advised to prescribe inhaled salmeterol as 'add-on' controller if trial participants have the Gly/Gly variant on ADRB2, and montelukast if they have Arg/Arg or Arg/Gly variant on ADRB2.

If an add-on controller is required, young people will be prescribed medication as per the choice of the primary or secondary care physician, without knowledge of genotypic status.

Asthma

If participants require add-on medication and have the Gly/Gly variant on the ADRB2, salmeterol will be prescribed.

Personalised medicine (Salmeterol)

If participants require add-on medication and have the Arg/Arg or Arg/Gly variant on the ADRB2, montelukast will be prescribed.

Personalised medicine (Montelukast)

If participants require add-on medication in the arm, they will be prescribed either salmeterol or montelukast according to health professional's choice based on current guidelines.

Standard care

Brighton & Sussex University Hospitals NHS Trust

Kent, Surrey & Sussex CCGs

NHS Grampian

NHS Tayside

Bart's Health NHS Trust

Prescribing Asthma Controller Medication According to Gene Status to Improve Quality of Life in Young People With Asthma

A disease-specific health-related quality of life instrument that taps both physical and emotional impact of disease. Participants are asked to think about how they have been during the previous 2 weeks and to respond to each of the 32 questions on a 7-point scale (7 = not bothered at all - 1 = extremely bothered).

The ACQ has 6 questions (the top scoring 5 symptoms, and daily rescue bronchodilator use). Patients are asked to recall how their asthma has been during the previous week and to respond to the symptom and bronchodilator use questions on a 7-point scale (0=no impairment, 6= maximum impairment).

Participants will be asked to record how many times they have had to visit their GP or asthma nurse (outside of routine asthma review), A&E or hospital as a result of their asthma over the previous 3 months. Total scores for health care utilisation will be summed over the 12-month study period to create a total score for health care utilisation for each participant. Participants will be asked to enter this data via on the online questionnaire at each 3-month follow up.

Participants will be asked to record any courses of oral corticosteroids for asthma and any other medication use over the last 3 months. Medication use (scored by each type of medicinal product) will be summed across the 12 month study period to create total number of additional medicinal product use for each participant. Participants will be asked to enter this data via on the online questionnaire at each 3-month follow up.

University of Sussex

The active comparator arm consists of Flixotide® (fluticasone propionate) via accuhaler (Diskus) dry powder inhaler device as per current inhaled steroid dose plus oral montelukast

The placebo comparator arm consists of Seretide® (salmeterol plus equivalent dose of fluticasone) via accuhaler dry powder inhaler device as per current inhaled steroid dose plus placebo for montelukast

Seretide 100 Accuhaler 1 dose twice daily plus 1 tablet daily of placebo montelukast
Seretide 250 Accuhaler 1 dose twice daily plus 1 tablet daily of placebo montelukast
Seretide 500 Accuhaler 1 dose twice daily plus 1 tablet daily of placebo montelukast
Doses of montelukast or placebo: up to 6 years 4 mg once daily; 6-14 years 5 mg once daily; 15 years and above 10 mg once daily

Montelukast Placebo

Flixotide Accuhaler 50 micrograms per blister, 1 blister dose twice daily plus 1 tablet daily of montelukast
Flixotide Accuhaler 100 micrograms per blister; 1 blister dose twice daily plus 1 tablet daily of montelukast
Flixotide Accuhaler 250 micrograms per blister; 1 blister dose twice daily plus 1 tablet daily of montelukast
Flixotide Accuhaler 500 micrograms per blister; 1 blister dose twice daily plus 1 tablet daily of montelukast
Doses of montelukast or placebo: up to 6 years 4 mg once daily; 6-14 years 5 mg once daily; 15 years and above 10 mg once daily

Salmeterol, Montelukast

Maternal and Child Health Sciences, Ninewells Hospital and Medical School

Add-on Salmeterol Versus Montelukast in Arg/Arg-16 Asthmatics

A Proof-of-concept Study to Evaluate the Benefit From add-on Therapy With Montelukast Versus Salmeterol in Children With Asthma Carrying the Arg/Arg-16 beta2-receptor Genotype

juniperus communis/противгабичен лек

Prescribing Asthma Controller Medication According to Gene Status to Improve Quality of Life in Young People With Asthma

Add-on Salmeterol Versus Montelukast in Arg/Arg-16 Asthmatics

Најкомплетната база на податоци за лековити билки поддржана од науката