Trial reportAnnals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology2022
Treatment by biomarker-informed endotype vs guideline care in children with difficult-to-treat asthma.
Trial report in Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04179461 (Personalized Treatment Algorithms for Difficult-to-treat Asthma), which is not on this map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Personalized Treatment Algorithms for Difficult-to-treat Asthma: Bench to Community
Who cites it
2 citing papers in PubMed.
- Therapeutic subtypes of knee osteoarthritis: differential treatment effects among predicted endotypes in past clinical trials.Arthritis research & therapy · 2026Article
- The Saudi initiative for asthma - 2024 update: Guidelines for the diagnosis and management of asthma in adults and children.Annals of thoracic medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
backgroundAsthma is heterogeneous, contributing to difficulty in disease management.
objectiveTo develop a biomarker-informed treatment model for difficult-to-treat (DTT) asthma and conduct a pilot feasibility study.
methodsSchool-aged children (n = 21) with DTT asthma were enrolled and completed 3 medical visits (V1-V3). V2 and V3 were completed approximately 3.5 months and 12 months after V1, respectively. At V1, guideline care and adherence interventions were initiated, and blood samples were collected for asthma biomarker assessment. A personalized treatment algorithm was developed based on biomarkers (treatment by endotype) and was implemented at V2. Asthma outcomes were compared from V1 to V2 (guideline-based care) to V2 to V3 (guideline + biomarker-informed care).
resultsOverall retention was 86%. There was an even distribution of participants with allergy, without allergy, and with mixed allergies. The participants received an average of 5.9 interventions (range, 3-9). The allergic phenotype was characterized by increased CDHR3 risk genotype and high transepidermal water loss. High serum interleukin-6 level was most notable in the mixed allergic subgroup. The nonallergic phenotype was characterized by vitamin D deficiency and poor steroid treatment responsiveness. The personalized treatment plans were associated with decreased emergency department visits (median, 1 vs 0; P = .04) and increased asthma control test scores (median, 22.5 vs 23.0; P = .01).
conclusionThe biomarker-based treatment algorithm triggered interventions on top of guideline care in all children with DTT asthma studied, supporting the need for this type of multipronged approach. Our findings identify the minimal biomarker set that is informative, reveal that this treatment-by-endotype intervention is feasible and may be superior to guideline care alone, and provide a strong foundation for a definitive trial.
trial registrationClinicalTrials.gov identifier: NCT04179461.
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Registered trials
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