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Persistent AsthmaARCANCT04480242

Asthma Research in Children and Adolescents

An observational study of Persistent Asthma and Asthma in Children, run by Parc de Salut Mar at 15 sites in Spain.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The purpose of this study is to assess the evolution of disease control, health-related quality of life, and the risk of severe asthma exacerbations in children and adolescents with persistent asthma in Spain at short, mid and long-term follow-up. Read more about this study

Who is it for?
Ages 6 to 14 years
What is being tested?
Inhaled Corticosteroids (ICs), Fixed-Dose Combination of Inhaled Corticosteroids and Long- Acting Beta-agonist (ICs/LABA) and Other treatments
How many people
525 participants
Where
15 sitesSpain
Study dates
26 Jul 2017to 31 Dec 2030
How long will I take part?
10 Years
Phase
Observational
Are there results?
Not yet: the study is under way

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 6 to 14 years
  • All sexes
  • No healthy volunteers
  • Child

Study population: Spanish children and adolescents with persistent asthma seen in the outpatient pediatric pulmonology clinics and primary care pediatricians.

Who may be able to join

  • Children or adolescents aged 6-14.
  • Clinical diagnosis of asthma.
  • Undergoing treatment with inhaled corticosteroids (alone or combined with long-acting beta-agonists) for more than 6 months in the previous year.
  • With access to a smart phone (their own, or their parents').

Who cannot join

  • Concomitant respiratory diseases:
  • Chronic obstructive pulmonary disease
  • Cystic fibrosis
  • Pulmonary fibrosis
  • Bronchiectasis
  • Active tuberculosis,
  • Immunodeficiency associated with alpha 1 antitrypsin deficiency
  • Ciliary diseases

Trial locations and contacts

15 sites in 1 country.

15 sites in 1 country

Spain15 sites
  • Hospital Universitario Araba

    Alava, Basque Country, 01009

  • Health Services Research Group, IMIM-Hospital del Mar Medical Research Institute

    Barcelona, Catalonia, 08003

  • Hospital del Mar

    Barcelona, Catalonia, 08003

  • Centro de Atención Primaria de la Vila Olímpica

    Barcelona, Catalonia, 08005

  • Hospital Vall d'Hebron

    Barcelona, Catalonia, 08035

  • Hospital Parc Taulí

    Barcelona, Catalonia, 08208

  • Centro de Salud de Jerez Sur

    Cadiz, Andalusia, 11408

  • Centro de Salud Segovia

    Madrid, Madrid, 28005

  • Centro de Salud Canillejas

    Madrid, Madrid, 28022

  • Centro de Salud Dos de Mayo Móstoles

    Madrid, Madrid, 28934

  • Centro de Salud La Candelaria

    Seville, Andalusia, 41006

  • Centro de Salud Dobra

    Torrelavega, Cantabria, 39300

  • Centro de Salud República de Argentina

    Valencia, Valencia, 46021

  • Centro de Salud Torre Ramona

    Zaragoza, Aragon, 500013

  • Hospital Miguel Servet

    Zaragoza, Aragon, 50009

Other trials in Spain

About this study

Official title: Assessment of Children and Adolescents With Asthma: An Observational Prospective Study

The purpose of this study is to assess the evolution of disease control, health-related quality of life, and the risk of severe asthma exacerbations in children and adolescents with persistent asthma in Spain at short, mid and long-term follow-up. Patient-reported information in this project is collected by computer assisted telephone interviews (CATI) and a mobile application (ARCA App).

Read the detailed description

Primary Objectives:

  1. To evaluate the asthma control in children and adolescents with persistent asthma, and its relationship with patient characteristics, treatment and health-related variables (treatment adherence, inhalation technique, inhaler device, asthma triggers, and smoking exposure, among others).
  2. To assess the health-related quality of life of children and adolescents with persistent asthma, and its relationship with patient characteristics, treatment and health-related variables (asthma control, treatment adherence and inhalation technique, inhaler device, asthma triggers, and smoking exposure, among others).
  3. To assess the risk of severe asthma exacerbations in children and adolescents with persistent asthma and its relationship with patient characteristics, treatment, and health-related variables (asthma control, treatment adherence and inhalation technique, inhaler device, health-related quality of life, asthma triggers, and smoking exposure, among others).

Secondary Objectives:

  1. To evaluate the effect of monitoring inhalation techniques on patients' performance according to recommended actions when using inhalers, and outcomes such as asthma control, health-related quality of life, and asthma exacerbations.
  2. To assess the treatment adherence in children and adolescents with persistent asthma, and its relationship with other treatment-related factors (inhaler technique, inhaler device, adherence attitudes, and beliefs about illness, inhaler and exacerbations, among others).
  3. To evaluate health inequalities in children and adolescents with asthma in Spain.

ARCA is a prospective multicenter observational study in children and adolescents with a clinical diagnosis of persistent asthma. This clinical diagnosis of asthma is defined as the presence of wheezing three times in the last year that improves with the use of bronchodilators. Participants are consecutively recruited in outpatient pediatric pulmonology hospital consultations and primary care physicians.

Patient-reported information is obtained by computer-assisted telephone interviews (CATI) and a mobile application (ARCA App). Telephone interviews are performed by trained interviewers to children 8-16 years old and parents/caregivers of children 6-7 years of age, immediately after recruitment and every 6 months. It includes the evaluation of asthma control, prescribed asthma treatment, adherence, and severe asthma exacerbations. Information about inhalation techniques, socioeconomic status, smoking exposure, triggers, use of peak flow, symptom diary, perceived asthma care, adherence attitudes, and beliefs about illness, inhaler and exacerbations is also collected.

The 'ARCA app' combines 3 age versions: parents/guardians (proxy response) for children 6-7 years old, children aged 8-11 years (self-response), and adolescents aged 12-16 years (self-response). The application consists in an interactive chat, simulating a conversation by Short Message Service (SMS) or Instant Messaging Application (WhatsApp) with someone in real time. It includes the monthly administration of 2 questions (global rating of change and severe asthma exacerbations). At the beginning, after downloading the app, and every two months different standardized questionnaires are administered by turns: the EuroQol (EQ-5D), the Pediatric Asthma Impact Scale (PAIS), inhalation techniques scale, and environment support. These latter scales are administered randomly to two groups of equal size, defined within the subsample recruited by each pediatrician.

All the information that each participant answers through the app can be viewed by the pediatrician through a specific platform. The results of the different questionnaires are shown in charts reflecting the patient's answers over time, using the traffic lights code: green for good outcomes, amber for intermediate, and red for poor. Clinical data is registered at recruitment and annually during the follow-up.

Sample size: To detect differences between two groups in the Asthma Control Questionnaire score of 0.3 SD, 175 patients per group would be required to have a statistical power of 80%, at a significance level of 5%.

Being tested
Inhaled Corticosteroids (ICs), Fixed-Dose Combination of Inhaled Corticosteroids and Long- Acting Beta-agonist (ICs/LABA), Other treatments, Inhaler device, Regularly monitoring of the Inhalation technique through mobile app

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Inhaled Corticosteroids (ICs)Drug

    Also called Treatments prescribed during regular clinical practice

    Any corticosteroid (beclomethasone, budesonide, ciclesonide, fluticasone propionate, fluticasone furoate, mometasone, and triamcinolone) prescribed by the pediatrician as an inhaled controller medication, for daily management of asthma. The daily dose of ICs prescribed will be translated into beclomethasone equivalent.

  • Fixed-Dose Combination of Inhaled Corticosteroids and Long- Acting Beta-agonist (ICs/LABA)Drug

    Also called Treatments prescribed during regular clinical practice

    Beclomethasone/formoterol, budesonide/formoterol, fluticasone furoate/vilanterol, fluticasone propionate/formoterol, fluticasone propionate/salmeterol, and mometasone/formoterol. Any of these combinations prescribed by the pediatrician as an inhaled controller medication, for daily management of asthma.

  • Other treatmentsDrug

    Also called Treatments prescribed during regular clinical practice

    Low-dose oral corticosteroids, long-acting muscarinic antagonist (tiotropium), low-dose macrolides (azithromycin), leukotrienes receptor antagonists (i.e. montelukast), or biologic agents (i.e. omalizumab).

  • Inhaler deviceDrug

    Also called Treatments prescribed during regular clinical practice

    Pressurized metered-dose inhalers (pMDIs), Breath-actuated pMDIs, Dry powder inhalers (DPIs), Nebulizers, Soft Mist Inhalers.

  • Regularly monitoring of the Inhalation technique through mobile appBehavioural

    App users are randomized within each pediatrician into two groups of equal size defined within the subsample recruited, so that 50% of the participants are allocated to answer the inhalation techniques, and the other 50% are allocated to answer the environment support scales. Once the app is downloaded, at month 2 and every 6 months thereafter the intervention group answers the inhalation techniques scale (group 1) and the control group answers the environment support scale (group 2).

Study groups in NCT04480242
Study groupRoleWhat they receive
Asthma Research in Children and Adolescents - Spanish CohortGroups defined according to treatments prescribed during regular clinical practice and to the exposure to inhalation techniques monitoring
Receives: Drug: Inhaled Corticosteroids (ICs); Drug: Fixed-Dose Combination of Inhaled Corticosteroids and Long- Acting Beta-agonist (ICs/LABA); Drug: Other treatments; Drug: Inhaler device; Behavioral: Regularly monitoring of the Inhalation technique through mobile app

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from baseline in symptoms control, measured with the Asthma Control Questionnaire (ACQ)

    Symptoms control is measured with the Asthma Control Questionnaire (ACQ-symptoms) only, which assesses the frequency of 5 asthma symptoms (night-time waking, symptoms on waking, activity limitation, shortness of breath, and wheeze) during the previous week on a 7-point Likert scale from 0 (no impairment) to 6 (maximum impairment). The overall score, calculated as the mean of item responses, ranges from 0 to 6. A score >1.5 is considered not well-controlled asthma, and scores <0.75 well-controlled asthma.

    Measured: 2, 5, 7 and 10 years after inclusion

  2. Change from baseline in Health-Related Quality of Life, measured with the EuroQol

    The EQ-5D consists of 5 dimensions ("mobility", "looking after myself", "doing usual activities", "having pain/discomfort" and "feeling worried/sad/unhappy). It includes also a visual analogue scale (EQ-VAS) on the general health status from 0 (worst health status) to 100 (best health status possible). The EQ-5D index ranges from 1 (best health state) to negative values (health states valued as worse than death), where 0 is equal to death, allowing the calculation of Quality-Adjusted Life-Years (QALYs).

    Measured: 2, 5, 7 and 10 years after downloading the ARCA app

  3. Number of severe asthmatic exacerbations

    As a screening to detect asthma exacerbation, the experience of asthma worsening question is administered through the ARCA app: "In the last month, have you had to take any pill, syrup, oral solution or go to the doctor or hospital, due to asthma worsening?" (Yes/No). If the answer is "yes", a phone call confirms or discards a severe asthma exacerbation through the following questions: "Did you visit or phone your general practitioner, out-of-hours, or walk-in center because your asthma got worse?", "Did you call an ambulance or go to the hospital because of your asthma?", "Did you take steroids tablets (such as Prednisolone or Deltacortril) for at least 2 days because of your asthma?" If the participant answers "yes" to at least one of the 3 questions, an asthma exacerbation is confirmed. These questions were constructed applying the definition of the American Thoracic Society and the European Respiratory Society.

    Measured: 5 and 10 years after inclusion

Secondary outcomes (3)
  1. Change from baseline in adherence to the treatment, measured with the Medication Intake Survey adherence scale-Asthma (MIS-A)

    Adherence is assessed separately for each controller inhaler, based on self-reported prescription start date, daily dosage recommendations and 3 questions on controller use over increasing time periods (day before, previous week, and previous month). Percentages of medication used versus prescribed are calculated first for each question, and subsequently as composite scores (0-100). The total score is categorized into complete (100%), intermediate, and low (50%) adherence. Medication abuse (temporary occasional) is also evaluated for each treatment.

    Measured: 2, 5, 7 and 10 years after inclusion

  2. Change from baseline in quality of the inhaler technique, measured with the Inhalation Technique Scale

    The Inhalation Technique Scale includes five questions on how often participants perform recommended actions when using inhalers, on a 5-point Likert scale from 0 (never) to 4 (always). The overall score, calculated as the mean of items responses, ranges from 0 to 4 points. Higher values indicate better inhaler technique.

    Measured: 2, 5, 7 and 10 years after downloading the ARCA app

  3. Change from baseline in the Pediatric Asthma Impact Scale (PAIS)

    The Patient-Reported Outcomes Measurement Information System (PROMIS) developed the short version of the Pediatric Asthma Impact Scale (PAIS), composed of 8 items assessing the past seven days in a 5-point response scale with the options: never, almost never, sometimes, often, and almost always. The total raw score (adding the values of the response to each question) is translated into a T-score with a mean of 50 and a standard deviation (SD) of 10. A score lower than 50 is one SD lower than the mean of the reference population.

    Measured: 2, 5, 7 and 10 years after downloading the ARCA app

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Jul 2020
  2. Study start26 Jul 2017
  3. Primary completion31 Oct 2025 (estimated)
  4. Study completion31 Dec 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
525 participants (estimated)
Target duration
10 Years
IDs, dates and publications
ClinicalTrials.gov ID
NCT04480242
Sponsor's protocol ID
ARCA2017
Other IDs
PI15/00449
Acronym
ARCA
Status last verified
May 2025
First submitted
13 Jul 2020
Last updated
31 Jul 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

An observational study of Persistent Asthma and Asthma in Children, run by Parc de Salut Mar at 15 sites in Spain.

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 4 inclusion and 8 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: under way, not looking for participants, as of the sponsor's last update on 31 Jul 2025. 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 Spain. 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.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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?

Change from baseline in symptoms control, measured with the Asthma Control Questionnaire (ACQ) (time frame: 2, 5, 7 and 10 years after inclusion). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 31 Jul 2025.

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