Asthma: could personalised treatment improve children’s quality of life?
Published on 4 March 2014
Around 1.1 million children in the UK have asthma, a lifelong condition that affects breathing.1 When asthma is managed well, children can lead a full and active life. However, Professor Somnath Mukhopadhyay, of Brighton’s Royal Alexandra Children's Hospital, has uncovered evidence that a commonly used asthma medicine, called salmeterol, may offer little benefit to some of the children who are taking it. He is investigating whether children’s genetic makeup should be taken into account when deciding whether to give them this asthma medicine or an alternative – whether this improves children’s quality of life and gives better control of their asthma.
How are children’s lives affected now?
One in every 11 children in the UK has asthma – one of the highest rates worldwide.1
“Children with asthma cough, wheeze and have difficulty breathing,” explains Professor Mukhopadhyay. “The children’s symptoms can mean they miss school and make it difficult for them to participate in playground games and sports. Some have to be admitted to hospital.”
Indeed, every 18 minutes a child is admitted to hospital in the UK because of asthma.1
Effective medicines are available, but a child’s response to treatment is currently unpredictable. This project focuses on a medicine called salmeterol. According to reports, tens of thousands of children may be taking this medicine in the UK, but evidence suggests it might not work for around one in seven of them.2-5
The consequences of ongoing asthma symptoms can be far reaching: “Children with poorly controlled asthma can develop low self-esteem because they fall behind their peers in football, PE and schoolwork. The family often sleep poorly as the child is coughing,” says Professor Mukhopadhyay.
How could this research help?
“We are investigating whether a new approach to treatment, where prescribing is personalised according to a child’s individual make-up, improves children’s quality of life and provides better control of their asthma,” says Professor Mukhopadhyay.
Treatment that is tailored in this way to a person’s genetic features is often called ‘personalised therapy’.
At the moment, doctors commonly prescribe salmeterol to relieve asthma symptoms if children don’t benefit enough from other medicines. But evidence suggests salmeterol may not work properly in children with a certain genetic makeup.
Professor Mukhopadhyay is investigating whether it helps to take children and young people’s genetic makeup into account when deciding whether to give them salmeterol or an alternative medicine called montelukast. A simple and inexpensive saliva test can provide the information needed to guide decision making.
“Our ultimate aim is to make the most of the treatments we’ve already got for asthma, so children get the medicines that suit them best – and they can enjoy the best possible quality of life,” says Professor Mukhopadhyay.
|Project Leader||Professor Somnath Mukhopadhyay MBBS MD PhD FRCPCH|
|Location||Academic Department of Paediatrics, Royal Alexandra Children's Hospital, Brighton and Sussex Medical School|
|Grant awarded||15 November 2013|
|Start date||1 May 2014|
|End date||30 September 2017|
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1. Asthma UK. Asthma facts and FAQs. http://www.asthma.org.uk/asthma-facts-and-statistics Website accessed 3 January 2014.
2. Lipworth BJ et al. Tailored second-line therapy in asthmatic children with the Arg16 genotype. Clinical Science 2013; 124: 521–528.
3. BBC News Health. Spit test ‘improves’ asthma care http://www.bbc.co.uk/news/health-20931946 Website accessed 3 January 2014.
4. Turner S et al. Prescribing trends in asthma: a longitudinal observational study. Arch Dis Child 2009; 94: 16–22.
5. Office for National Statistics. UK population estimated to be 63.7 million in mid-2012. Chart Population pyramid for the UK; mid-2012 compared with mid-2001. http://www.ons.gov.uk/ons/rel/pop-estimate/population-estimates-for-uk--... Website accessed 12 February 2014.