Asthmatic children who remain symptomatic on inhaled corticosteroids (ICS) require an adjustment of their asthma therapy. Current guidelines suggest that the treatment options are either an increased dose of inhaled corticosteroid or the addition of other therapy such as a long-acting beta-agonist (LABA). In the pediatric age range, major concerns with respect to high dose ICS therapy are growth retardation and the suppression of the hypothalamic-pituitary-adrenocortical (HPA) axis. Previous studies in adults have shown that a combination product that included a LABA as well as the ICS allowed to reduce the steroid dose and was still at least as effective in achieving asthma control as treatment with a higher dose of ICS. These treatment options shall be compared in the present study. Children who remain symptomatic while inhaling 100 µg fluticasone (FP) twice daily shall be randomized to receive the salmeterol/ fluticasone combination product, Viani (SERETIDE) 50/100 µg, or fluticasone 200 µg as a comparator drug, inhaled twice daily via the DISKUS for a period of eight weeks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Enrollment
285
Salmeterol/ fluticasone are a type of long acting beta-agonist (LABA). Salmeterol 50 microgram/ fluticasone 100 microgram combination will be administered to eligible subjects via inhalation route.
Fluticasone propionate is a type of LABA. Fluticasone 100 microgram dose will be administered to eligible subjects via inhalation route.
Salbutamol metered dose inhaler will be provided to all subjects as a rescue medication.
GSK Investigational Site
Bad Krozingen, Baden-Wurttemberg, Germany
GSK Investigational Site
Bönnigheim, Baden-Wurttemberg, Germany
GSK Investigational Site
Ettenheim, Baden-Wurttemberg, Germany
GSK Investigational Site
Heidelberg, Baden-Wurttemberg, Germany
GSK Investigational Site
Kehl, Baden-Wurttemberg, Germany
Change from Baseline in mean morning peak expiratory flow (PEF)
The PEF is a person's maximum speed of expiration. PEF will be measured using a mini wright peak flow meter and will be documented daily at morning in the diary of subjects
Time frame: Baseline up to Week 8
Daily Asthma symptom score
Asthma symptoms will be recorded separately for night and day using 2 symptom scores. Symptoms included will be coughing, wheezing, shortness of breath, feeling of tightness in the chest and nocturnal waking due to 1 or more of these symptoms. Score will range from 0-4 where 0 = no complaints and 4= person could not sleep due to asthma symptoms.
Time frame: Up to Week 8
Number of calendar days without asthma symptoms
Number of calendar days without asthma symptoms will be defined as the sum of all days for which the patient documented an asthma symptom score of 0 (no complaints) for the day and the previous night.
Time frame: Up to Week 8
Number of necessary administrations of salbutamol
The number of necessary administrations of salbutamol will be documented daily by subjects in the diary.
Time frame: Up to Week 8
Number of weeks with good asthma control
One week of well controlled asthma will be defined by fulfilling the following criteria: at least 2 of the following criteria (type A): symptoms with a symptom score \>1 on at most 2 days, use of rescue medication maximally 4 x per week, morning PEF daily \>=80% of the predicted normal value and all the following criteria (type B): no nocturnal waking due to bronchial asthma, no exacerbations, no out-patient or hospitalized emergency treatment due to asthma, no adverse events due to administration of the study medication which would have necessitated a change of treatment, no intolerance or refusal of study medication
Time frame: Up to Week 8
Change in forced vital capacity (FVC) in % of reference value
FVC is the amount of air which can be forcibly exhaled from the lungs after taking the deep breath.
Time frame: Up to Week 8
Change in forced expiratory volume in 1 second (FEV1) in % of reference value
FEV1 is the volume of air exhaled under forced conditions in 1 second.
Time frame: Up to Week 8
Change in peak expiratory flow rate (PEFR) in % of reference value
PEFR is a person's maximum speed of expiration.
Time frame: Up to Week 8
Change in mean morning peak flow in % of reference value
The PEF is a person's maximum speed of expiration. PEF will be measured using a mini wright peak flow meter
Time frame: Up to Week 8
Percentage of subjects with a peak flow variability of 20%
Morning versus evening peak flow will be calculated and compared.
Time frame: Up to Week 8
Number of subject withdrawals due to asthma exacerbations
Asthma exacerbations are acute or sub acute episodes, which are characterized by a progressive increase in one or more typical asthma symptoms.
Time frame: Up to Week 8
Number of subjects with adverse events (AEs)
An AE is any untoward medical occurrence in a clinical investigation subject, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product.
Time frame: Up to Week 8
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GSK Investigational Site
Konstanz, Baden-Wurttemberg, Germany
GSK Investigational Site
Mannheim, Baden-Wurttemberg, Germany
GSK Investigational Site
Pfullendorf, Baden-Wurttemberg, Germany
GSK Investigational Site
Schwäbisch Hall, Baden-Wurttemberg, Germany
GSK Investigational Site
Schwetzingen, Baden-Wurttemberg, Germany
...and 88 more locations