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Children's asthma medicine warning

Children with asthma may be using medicines that do not work and in some cases this could increase their suffering, according to a study.

The inhaler, which is often the first line of treatment in asthma, could be less effective or may even make the condition worse for some children carrying a particular gene change, research at the Brighton and Sussex Medical School (BSMS) has shown.

The researchers' concerns follow the publication of the first national study of asthma deaths in the UK, which claimed some asthma patients are dying because of complacency among both medical staff and patients.

BSMS experts are planning new trials this autumn which they believe will provide further evidence to support the idea of providing personalised medicine to improve treatment.

Professor Somnath Mukhopadhyay, chairman of Paediatrics at BSMS who is heading the research, said: "Both asthma 'reliever' and 'controller' medicines may not work well in a proportion of children because the child's genetic make-up makes the medicine less effective.

"A simple test can determine whether a child carries the gene change and identify those who might benefit from a switch to an alternative, more effective medicine."

Prof Mukhopadhyay said parents and health professionals should be made more aware of the possible risks to children who carry the gene change.

The research has been funded by the charity Haydn's Wish, named after nine-year-old asthma sufferer Haydn Wileman, from Newhaven, East Sussex, who died in 2011 after an allergic reaction.

The charity, which supports the BSMS research, said the audit showed many parents of children with asthma felt the blue inhaler did not work well.

Haydn's mother Emma Wileman, who leads the charity, said: "Some children with asthma appear to be suffering more because they are not responding to 'reliever' medicine.

"We believe parents need to be made more aware of this and there should be more research, as a matter of urgency."

BSMS, a partnership between the universities of Brighton and Sussex, will lead the new trials at several UK centres.

GPs, hospital doctors and asthma nurses will work with parents to find out whether personalised treatment can improve the lives of children with asthma.

Prof Mukhopadhyay said: "Treatment that is personalised for each child on the basis of his or her genetic status could make asthma medicines more effective in controlling symptoms and reducing the risk of asthma attacks."

Earlier research showed that traditional asthma medicines like salmeterol and salbutamol, when added on to inhaled steroids, may not improve symptoms for one in seven children with asthma who carry the particular gene change, and that the children respond better to an alternative anti-inflammatory asthma medicine.

The latest study will use parent choice to help compare the benefits of the current treatment against a novel way of treating asthma where parents and health professionals consider selecting asthma medicines by matching the child's gene information with their response to existing treatments.

Both groups of children will be followed up on and checked after one year, the researchers said.

The new £200,000 trial is being funded by children's charity Action Medical Research, and physicians and geneticists from London, Dundee and Aberdeen will be taking part.

A complementary study, led by Prof Mukhopadhyay in collaboration with Haydn's Wish, is being funded by a Department of Health Research for Patient Benefit grant worth £257,000.

It will explore underlying differences in airway responses to salbutamol between wheezy children with normal genotype against those affected by these genetic changes.

This will help doctors understand the differences in airway response that may underlie the changes, a university spokesman said.

The Department of Health study is based mainly in Brighton and will be conducted in collaboration with NHS colleagues. A parent representative will help ensure the research remains well-grounded and focused on benefit for children and families. Both studies are supported by NHS Research and Development in England and Scotland.


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