About: Determinants Of Oral corticosteroid Responsiveness in Wheezing Asthmatic Youth (DOORWAY): protocol for a prospective multicentre cohort study of children with acute moderate-to-severe asthma exacerbations

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About: Determinants Of Oral corticosteroid Responsiveness in Wheezing Asthmatic Youth (DOORWAY): protocol for a prospective multicentre cohort study of children with acute moderate-to-severe asthma exacerbations Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Determinants Of Oral corticosteroid Responsiveness in Wheezing Asthmatic Youth (DOORWAY): protocol for a prospective multicentre cohort study of children with acute moderate-to-severe asthma exacerbations
Creator	Ducharme, Francine Fm, Ducharme
Source	Medline; PMC
abstract	INTRODUCTION: Oral corticosteroids are the cornerstone of acute asthma management in the emergency department. Recent evidence has raised doubts about the efficacy of this treatment in preschool-aged children with viral-induced wheezing and in smoking adults. The aims of the study were to: (1) document the magnitude of response to oral corticosteroids in children presenting to the emergency department with moderate or severe asthma; (2) quantify potential determinants of response to corticosteroids and (3) explore the role of gene polymorphisms associated with the responsiveness to corticosteroids. METHODS AND ANALYSIS: The design is a prospective cohort study of 1008 children aged 1–17 years meeting a strict definition of asthma and presenting with a clinical score of ≥4 on the validated Pediatric Respiratory Assessment Measure. All children will receive standardised severity-specific treatment with prednisone/prednisolone and cointerventions (salbutamol with/without ipratropium bromide). Determinants, namely viral aetiology, environmental tobacco smoke and single nucleotide polymorphism, will be objectively documented. The primary efficacy endpoint is the failure of emergency department (ED) management within 72 h of the ED visit. Secondary endpoints include other measures of asthma severity and time to recovery within 7 days of the index visit. The study has 80% power for detecting a risk difference of 7.5% associated with each determinant from a baseline risk of 21%, at an α of 0.05. ETHICS AND DISSEMINATION: Ethical approval has been obtained from all participating institutions. An impaired response to systemic steroids in certain subgroups will challenge the current standard of practice and call for the immediate search for better approaches. A potential host–environment interaction will broaden our understanding of corticosteroid responsiveness in children. Documentation of similar effectiveness of corticosteroids across determinants will provide the needed reassurance regarding current treatment recommendations. RESULTS: Results will be disseminated at international conferences and manuscripts targeted at emergency physicians, paediatricians, geneticists and respirologists. TRIAL REGISTRATION NUMBER: This study is registered at Clinicaltrials.gov (NCT02013076).
has issue date	2014-04-05(xsd:dateTime)
bibo:doi	10.1136/bmjopen-2013-004699
bibo:pmid	24710133
has license	cc-by-nc
sha1sum (hex)	afb768d18ca2b01aacb890d056487c1a00681e72
schema:url	https://doi.org/10.1136/bmjopen-2013-004699
resource representing a document's title	Determinants Of Oral corticosteroid Responsiveness in Wheezing Asthmatic Youth (DOORWAY): protocol for a prospective multicentre cohort study of children with acute moderate-to-severe asthma exacerbations
has PubMed Central identifier	PMC3987727
has PubMed identifier	24710133
schema:publication	BMJ Open
resource representing a document's body	covid:afb768d18ca2b01aacb890d056487c1a00681e72#body_text
is schema:about of	named entity 'ASTHMA EXACERBATIONS' named entity 'YOUTH' named entity 'WHEEZING' named entity 'ORAL' named entity 'ACUTE' named entity 'CORTICOSTEROIDS' named entity 'ASTHMA MANAGEMENT' named entity 'PROTOCOL' named entity 'PROSPECTIVE' named entity 'ASTHMATIC' named entity 'SEVERE ASTHMA' named entity 'COHORT STUDY' named entity 'RESPONSIVENESS' named entity 'CHILDREN' named entity 'ORAL' named entity 'DETERMINANTS' named entity 'MODERATE-TO-SEVERE' named entity 'CORTICOSTEROID' named entity 'EMERGENCY DEPARTMENT' named entity 'ACUTE ASTHMA' named entity 'cornerstone' named entity 'corticosteroids' named entity 'acute asthma' named entity 'Wheezing' named entity 'Asthmatic' named entity 'Asthmatic' named entity 'Canadian' named entity 'triage' named entity 'influenza A/H1N1' named entity 'acute care' named entity 'salbutamol' named entity 'anticholinergics' named entity 'absolute contraindication' named entity 'asthma' named entity 'wheezing' named entity 'prospective cohort study' named entity 'xenobiotic' named entity 'paediatric' named entity 'genotypes' named entity 'paediatric' named entity 'asthma' named entity 'inflammatory mediators' named entity 'ETS' named entity 'genetic heterogeneity' named entity 'polymorphisms' named entity 'logistic regression' named entity 'radiologist' named entity 'SNPs' named entity 'GSTP1' named entity 'area under the curve' named entity 'IL-8' named entity 'bronchiolitis' named entity 'Sputum' named entity 'correlation' named entity 'corticosteroids' named entity 'ipratropium bromide' named entity 'saliva' named entity 'antileukotrienes' named entity 'asthma' named entity 'airway obstruction' named entity 'nasopharyngeal swab' named entity 'eosinophils' named entity 'nitric oxide' named entity 'agonist' named entity 'operational definition' named entity 'iNOS' named entity 'corticosteroid' named entity 'corticosteroids' named entity 'agonists' named entity 'acute asthma' named entity 'area under the curve' named entity 'sample size' named entity 'neutrophils' named entity 'corticosteroids' named entity 'corticosteroids' named entity 'area under the curve' named entity 'symptom' named entity 'young children' named entity 'allergy test' named entity 'pathogenesis'

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