AsthmaPhase 3AVICANCT01606319
Acetaminophen Versus Ibuprofen in Children With Asthma
A Phase 3 study testing Acetaminophen and Ibuprofen in people with Asthma and Wheezing, run by Milton S. Hershey Medical Center at 15 sites in United States.
Trial summary
The Acetaminophen Versus Ibuprofen in Children with Asthma study will test the primary hypothesis that in preschool children 12-59 months of age with persistent asthma on standardized asthma therapy, the number of asthma exacerbations requiring systemic corticosteroids will be more frequent in children randomized to… Read more about this study
- Who is it for?
- Ages 12 to 59 months
- What is being tested?
- Acetaminophen and Ibuprofen
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 300 participants
- Where
- 15 sitesUnited States
- Study dates
- Feb 2013to Apr 2015
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 12 to 59 months
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- 12-59 months of age.
- If the child is not currently taking long-term asthma controller therapy (meaning that the child has taken no inhaled corticosteroid or leukotriene receptor antagonist medication whatsoever over the past 6 months), then one of the following criteria must be met:
- Daytime asthma symptoms more than two days per week (average over the past 4 weeks),
- At least one nighttime awakening from asthma (over the past 4 weeks),
- Two or more asthma exacerbations requiring systemic corticosteroids in the previous 6 months,
- Four or more wheezing episodes in the previous 12 months.
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- If the child is currently taking long-term asthma controller therapy (meaning that the child has taken daily or intermittent/as-needed inhaled corticosteroid or leukotriene receptor antagonist over the past 6 months), then one of the following criteria must be met:
- Taking inhaled corticosteroid or leukotriene receptor antagonist for more than 3 months (or more than 90 days) out of the previous 6 months (or 180 days),
- Daytime asthma symptoms more than two days per week (average over the past 4 weeks),
- More than one nighttime awakening from asthma (over the past 4 weeks),
- Two or more asthma exacerbations requiring systemic corticosteroids in the previous 12 months,
- Four or more wheezing episodes in the previous 12 months.
- Up to date with immunizations, including varicella (unless the subject has already had clinical varicella).
- Willingness to provide informed consent by the child's parent or guardian.
Who cannot join
- Allergic reaction to the study medications or any component of the study drugs, including (but not limited to) urticaria, rash, angioedema, or hypotension following delivery,
- Chronic medical disorders that could interfere with drug metabolism/excretion (for instance chronic hepatic, biliary, or renal disease),
- Chronic medical disorders that may increase the risk of drug-related injury, including (but not limited to):
- Osteogenesis imperfecta (increased risk of bone demineralization/fracture with corticosteroid therapy),
- Crohn's disease, ulcerative colitis, juvenile rheumatoid arthritis, clotting disorders, or Factor deficiency (increased risk of bleeding with corticosteroid therapy),
- G6PD deficiency (increased risk of hemolytic anemia with acetaminophen use),
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- Phenylketonuria (potential for aspartame exposure with study interventions),
- Seizure disorder treated with anticonvulsants (risk of acetaminophen toxicity with carbamazepine), or
- History of clotting disorders or Factor deficiency (increased risk of bleeding with corticosteroids),
- Co-morbid disorders associated with wheezing including (but not limited to) immune deficiency disorders, cystic fibrosis, aspiration, clinically-relevant gastroesophageal reflux, tracheomalacia, congenital airway anomalies (clefts, fistulas, slings, rings), bronchiectasis, bronchopulmonary dysplasia, and/or history of premature birth before 35 weeks gestation,
- Significant developmental delay/failure to thrive, defined as 5th percentile for height and/or weight or crossing of two major percentile lines during the last year for age and sex,
- History of a near-fatal asthma exacerbation requiring intubation or assisted ventilation,
- No primary medical caregiver (e.g., a nurse practitioner, physician assistant, physician, or group medical practice such as a hospital-based clinic) whom the subject can contact for primary medical care,
- Three or more hospitalizations in the previous 12 months for wheezing or respiratory illnesses,
- Treatment with 5 or more courses of systemic corticosteroids (oral, intramuscular or intravenous) in the past 6 months,
- Current use of higher than step 2 NAEPP asthma guideline therapy
- If receiving allergy shots, change in the dose within the past 3 months.
Trial locations and contacts
15 sites in 1 country.
15 sites in 1 country
United States15 sites
Emory University
Atlanta, Georgia, 30322
Children's Hospital Boston
Boston, Massachusetts, 02115
Children's Hospital, Boston
Boston, Massachusetts, 02115
University of Virginia Health System
Charlottesville, Virginia, 22908
Rush University Medical Center/Stroger Hospital
Chicago, Illinois, 60612
Children's Memorial Hospital
Chicago, Illinois, 60614
Rainbow Babies and Children's Hospital, Case Western Reserve University
Cleveland, Ohio, 44106
National Jewish Health
Denver, Colorado, 80206
University of Wisconsin-Madison
Madison, Wisconsin, 53792
Children's Hospital & Research Center Oakland
Oakland, California, 94609
Children's Hospital of Pittsburgh of UPMC
Pittsburgh, Pennsylvania, 15224
UCSF Benioff Children's Hospital
San Francisco, California, 94143
St. Louis Children's Hospital
St Louis, Missouri, 63110
University of Arizona College of Medicine
Tucson, Arizona, 85724
Wake Forest University Health Sciences
Winston-Salem, North Carolina, 27157
About this study
Official title: Acetaminophen vs. Ibuprofen in Children With Asthma
The Acetaminophen Versus Ibuprofen in Children with Asthma study will test the primary hypothesis that in preschool children 12-59 months of age with persistent asthma on standardized asthma therapy, the number of asthma exacerbations requiring systemic corticosteroids will be more frequent in children randomized to receive acetaminophen as compared to those randomized to receive ibuprofen on an as needed basis for fevers and pain.
Read the detailed description
AVICA is a 48-week randomized therapeutic trial involving two parallel treatment arms: acetaminophen and ibuprofen. Participating children will be randomized to receive either acetaminophen or ibuprofen administered as needed per parental decision for fever and analgesia. This study will address which is the most appropriate antipyretic-analgesic medication in young children with asthma, and will inform both clinicians and parents seeking to treat children with fever and pain. Given the high frequency of administration of these drugs, this study will have a significant impact on pediatric healthcare regardless of whether a differential effect is discovered as significant uncertainty currently exists as to whether acetaminophen use is associated with increased asthma symptoms.
- Being tested
- Acetaminophen, Ibuprofen
- Keywords
- Asthma, Wheezing, Ibuprofen, Acetaminophen, exacerbations, pain, fever
- Medical subject headings
- Asthma, Respiratory Sounds, Pain, Fever
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AcetaminophenDrug
Also called tylenol, paracetamol
15 mg/kg every 6 hours as needed
IbuprofenDrug
Also called motrin, advil, nonsteroidal anti-inflammatory drug
9.4 mg/kg every 6 hours as needed
| Study group | Role | What they receive |
|---|---|---|
| acetaminophen | Experimental | acetaminophen given as needed for pain or fever Receives: Drug: Acetaminophen |
| ibuprofen | Experimental | ibuprofen given as needed for pain or fever Receives: Drug: Ibuprofen |
What is being measured
The primary outcome is the main question the study is designed to answer.
Exacerbation Frequency
the number of asthma exacerbations requiring systemic corticosteroids
Measured: last 46 weeks of 48 week treatment period
Secondary outcomes (3)
Asthma Control Days
proportion of study days on which asthma was controlled, measured by electronic diary
Measured: last 46 weeks of 48 week treatment period
Asthma Rescue Medication Use
average albuterol rescue use per week, measured by electronic diary
Measured: last 46 weeks of 48 week treatment period
Health Care Utilization
frequency of unscheduled physician visits, emergency department visits or hospitalizations for asthma
Measured: last 46 weeks of 48 week treatment period
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 May 2012 (estimated)
- Study startFeb 2013
- Primary completionApr 2015
- Study completionApr 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for AsthmaStudies of the same condition, open and under way.
- More trials run by Milton S. Hershey Medical CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 300 participants (actual)
Sponsor and investigators
- Lead sponsor
- Milton S. Hershey Medical Center
- Sponsor type
- University, hospital or other
- Collaborators
- National Heart, Lung, and Blood Institute (NHLBI)
- Responsible party
- Principal investigator, dave mauger, Milton S. Hershey Medical Center
- Investigators
- William B Busse, MD, Study chair, University of Wisconsin, Madison
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01606319
- Sponsor's protocol ID
- AsthmaNet 005
- Other IDs
- 1U10HL098115
- Acronym
- AVICA
- Status last verified
- Nov 2016
- First submitted
- 23 May 2012
- Last updated
- 16 Jan 2017
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Sheehan WJ, Mauger DT, Paul IM, Moy JN, Boehmer SJ, Szefler SJ, Fitzpatrick AM, Jackson DJ, Bacharier LB, Cabana MD, Covar R, Holguin F, Lemanske RF Jr, Martinez FD, Pongracic JA, Beigelman A, Baxi SN, Benson M, Blake K, Chmiel JF, Daines CL, Daines MO, Gaffin JM, Gentile DA, Gower WA, Israel E, Kumar HV, Lang JE, Lazarus SC, Lima JJ, Ly N, Marbin J, Morgan WJ, Myers RE, Olin JT, Peters SP, Raissy HH, Robison RG, Ross K, Sorkness CA, Thyne SM, Wechsler ME, Phipatanakul W; NIH/NHLBI AsthmaNet. Acetaminophen versus Ibuprofen in Young Children with Mild Persistent Asthma. N Engl J Med. 2016 Aug 18;375(7):619-30. doi: 10.1056/NEJMoa1515990.
PubMed 27532828
Study at a glance
From the registry record, last updated by the sponsor on 16 Jan 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Acetaminophen vs. Ibuprofen in Children With Asthma
- ClinicalTrials.gov ID
- NCT01606319
- Acronym / sponsor ID
- AVICA / AsthmaNet 005
- Keywords
- Asthma, Wheezing, Ibuprofen, Acetaminophen, exacerbations, pain, fever
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 300 participants (actual)
- Lead sponsor
- Milton S. Hershey Medical CenterUniversity, hospital or other
- Collaborators
- National Heart, Lung, and Blood Institute (NHLBI)
- Study start
- Feb 2013
- Primary completion
- Apr 2015 (actual)
- Study completion
- Apr 2015 (actual)
- First posted
- 25 May 2012 (estimated)
- Results
- Posted 16 Jan 2017
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The Acetaminophen Versus Ibuprofen in Children with Asthma study will test the primary hypothesis that in preschool children 12-59 months of age with persistent asthma on standardized asthma therapy, the number of asthma exacerbations requiring systemic corticosteroids will be more frequent in children randomized to receive acetaminophen as compared to those randomized to receive ibuprofen on an as needed basis for fevers and pain.
Detailed description
AVICA is a 48-week randomized therapeutic trial involving two parallel treatment arms: acetaminophen and ibuprofen. Participating children will be randomized to receive either acetaminophen or ibuprofen administered as needed per parental decision for fever and analgesia. This study will address which is the most appropriate antipyretic-analgesic medication in young children with asthma, and will inform both clinicians and parents seeking to treat children with fever and pain. Given the high frequency of administration of these drugs, this study will have a significant impact on pediatric healthcare regardless of whether a differential effect is discovered as significant uncertainty currently exists as to whether acetaminophen use is associated with increased asthma symptoms.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| acetaminophen | Experimental | Drug: Acetaminophenacetaminophen given as needed for pain or fever |
| ibuprofen | Experimental | Drug: Ibuprofenibuprofen given as needed for pain or fever |
Who may qualify
- Ages
- 12 to 59 months
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (14 listed)
- 12-59 months of age.
- If the child is not currently taking long-term asthma controller therapy (meaning that the child has taken no inhaled corticosteroid or leukotriene receptor antagonist medication whatsoever over the past 6 months), then one of the following criteria must be met:
- If the child is currently taking long-term asthma controller therapy (meaning that the child has taken daily or intermittent/as-needed inhaled corticosteroid or leukotriene receptor antagonist over the past 6 months), then one of the following criteria must be met:
- Up to date with immunizations, including varicella (unless the subject has already had clinical varicella).
- Willingness to provide informed consent by the child's parent or guardian.
Key exclusion criteria (17 listed)
- Allergic reaction to the study medications or any component of the study drugs, including (but not limited to) urticaria, rash, angioedema, or hypotension following delivery,
- Chronic medical disorders that could interfere with drug metabolism/excretion (for instance chronic hepatic, biliary, or renal disease),
- Chronic medical disorders that may increase the risk of drug-related injury, including (but not limited to):
- Co-morbid disorders associated with wheezing including (but not limited to) immune deficiency disorders, cystic fibrosis, aspiration, clinically-relevant gastroesophageal reflux, tracheomalacia, congenital airway anomalies (clefts, fistulas, slings, rings), bronchiectasis, bronchopulmonary dysplasia, and/or history of premature birth before 35 weeks gestation,
- Significant developmental delay/failure to thrive, defined as 5th percentile for height and/or weight or crossing of two major percentile lines during the last year for age and sex,
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AcetaminophenAlso: tylenol, paracetamol15 mg/kg every 6 hours as needed | Drug | acetaminophen |
| IbuprofenAlso: motrin, advil, nonsteroidal anti-inflammatory drug9.4 mg/kg every 6 hours as needed | Drug | ibuprofen |
Primary outcome
Exacerbation Frequency
Time frame: last 46 weeks of 48 week treatment period
the number of asthma exacerbations requiring systemic corticosteroids
3 secondary outcomes
Asthma Control Days
Time frame: last 46 weeks of 48 week treatment period
Asthma Rescue Medication Use
Time frame: last 46 weeks of 48 week treatment period
Health Care Utilization
Time frame: last 46 weeks of 48 week treatment period
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Jan 2017.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 27532828Sheehan WJ, Mauger DT, Paul IM, Moy JN, Boehmer SJ, Szefler SJ, Fitzpatrick AM, Jackson DJ, Bacharier LB, Cabana MD, Covar R, Holguin F, Lemanske RF Jr, Martinez FD, Pongracic JA, Beigelman A, Baxi SN, Benson M, Blake K, Chmiel JF, Daines CL, Daines MO, Gaffin JM, Gentile DA, Gower WA, Israel E, Kumar HV, Lang JE, Lazarus SC, Lima JJ, Ly N, Marbin J, Morgan WJ, Myers RE, Olin JT, Peters SP, Raissy HH, Robison RG, Ross K, Sorkness CA, Thyne SM, Wechsler ME, Phipatanakul W; NIH/NHLBI AsthmaNet. Acetaminophen versus Ibuprofen in Young Children with Mild Persistent Asthma. N Engl J Med. 2016 Aug 18;375(7):619-30. doi: 10.1056/NEJMoa1515990.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
William B Busse, MD study chair
University of Wisconsin, Madison
15 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Acetaminophen and Ibuprofen in people with Asthma and Wheezing, run by Milton S. Hershey Medical Center at 15 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 14 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 16 Jan 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 15 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 16 Jan 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Exacerbation Frequency (time frame: last 46 weeks of 48 week treatment period). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01606319, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Jan 2017.