SynthesisAllergy2025
Genotype-Guided Asthma Treatment Reduces Exacerbations in Children: Meta-Analysis of Two Randomized Control Trials.
Synthesis in Allergy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed.
- Effect of IL-4RαR576 polymorphism on response to dupilumab in asthma, a genotype-stratified, randomized, placebo- controlled trial (IDEA trial): design, rationale, methods, strategies, and lessons learned.The Journal of asthma : official journal of the Association for the Care of Asthma · 2026Article
- Reframing paucigranulocytic asthma through genetic endotyping: a hypothesis-generating focus on the 17q21 rs7216389 locus.Current opinion in allergy and clinical immunology · 2026Review
- Five tenets for advancing evidence-based precision medicine.Nature medicine · 2026Review
- Precision Medicine for Asthma: Tailored to its Severity and Endotype/Phenotype.Allergy, asthma & immunology research · 2026Review
- The role of theERJ open research · 2025Article
- Unveiling the Complexities of Pediatric Asthma Treatment: Evidence, Controversies, and Emerging Approaches.Paediatric drugs · 2025Review
Corrections and comments
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Authors and funding
38 authors.
Funding
Abstract
backgroundLong-acting beta2-agonists (LABA) in combination with inhaled corticosteroids (ICS) are commonly used to treat asthma, however, some children lack response to the addition of LABA. This might be partially due to the presence of the Arg16Gly polymorphism, encoded by rs1042713 G>A in the ADRB2 gene. Carrying the A allele (Arg16) at this variant has been associated with an increased risk of exacerbations despite LABA treatment. We investigated whether genotype-guided treatment improved asthma-related outcomes.
methodsWe conducted an individual participant data meta-analysis of two randomised controlled trials: PUFFIN (Dutch and Swiss 6-18 year-olds) and PACT (English and Scottish 12-18 year-olds). Children with uncontrolled asthma despite ICS who required a step-up in treatment were included. Participants were randomised to genotype-guided treatment or the control group with a follow-up of at least 6 months. Genotype-guided treatment consisted of adding LABA for children with ADRB2 Gly16/Gly16, whilst children with ADRB2 Arg16/Arg16 or Arg16/Gly16 were treated with double dose ICS (PUFFIN) or add-on montelukast (PACT). The primary outcome was a change in asthma control; secondary outcomes included exacerbation rate and time to exacerbation. Repeated measures mixed models and Cox regression were used.
resultsFifty-nine out of 102 (PUFFIN) and 59 out of 91 (PACT) children had at least one Arg (A allele). Amongst all 193 children, no difference was observed in asthma control between the study groups. However, genotype-guided treatment resulted in lower asthma exacerbation rates (-0.08 (95%CI -0.16 to -0.00, p = 0.04)) compared to the control group.
conclusionGenotype-guided step-up treatment for children with uncontrolled asthma on ICS may lower asthma exacerbation rates and may be useful for personalising asthma care.
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Registered trials
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