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Longitudinal Observational Study of Severe Asthma

This study is currently recruiting participants. (see Contacts and Locations)
Verified November 3, 2016 by National Institutes of Health Clinical Center (CC)
Information provided by (Responsible Party):
National Institutes of Health Clinical Center (CC) ( National Heart, Lung, and Blood Institute (NHLBI) ) Identifier:
First received: January 29, 2013
Last updated: April 20, 2017
Last verified: November 3, 2016


- Asthma is a lung condition that causes difficulty breathing and decreased lung function. Some people with asthma have more severe disease symptoms. They may be less responsive to standard treatments such as steroids. Researchers want to compare severe asthmatics with mild or moderate asthmatics or people without asthma over a long period. This information may help identify new treatments for people whose asthma is not well controlled by standard medications.


- To compare severe asthmatics with mild or moderate asthmatics, and healthy volunteers, to study the progression and outcomes of the disease.


  • Individuals at least 18 years of age who have been diagnosed with asthma for at least 1 year.
  • Healthy volunteers at least 18 years of age.


  • This study will involve an initial visit to the NIH Clinical Center for all participants. Selected participants may be asked to return for repeat visits over a number of years. The test results from participants with asthma will be compared with those from the healthy volunteers.
  • All participants will be screened with a physical exam and medical history.
  • Participants may (but will not necessarily) have the following tests at each visit:
  • Complete medical history and physical exam
  • Blood, urine, sputum, and nasal cell samples
  • Breath tests and heart and lung function tests
  • Six-minute walk test to measure ability to exercise
  • Imaging studies such as chest x-rays, bone density scans, and sinus scans
  • Allergy skin testing
  • Vocal cord exam
  • Overnight sleep study
  • Participants may remain on the study for as long as they are willing to participate and do not develop health problems that will interfere with the study.


Study Type: Observational
Study Design: Time Perspective: Prospective
Official Title: Longitudinal Observational Study of Severe Asthma

Further study details as provided by National Institutes of Health Clinical Center (CC):

Primary Outcome Measures:
  • To collect longitudinal data regarding the natural history, co-morbid conditions, complications and outcomes of severe asthmatics as compared to mild or moderate asthmatics and non-ashmatics [ Time Frame: 20 years ]

Estimated Enrollment: 600
Study Start Date: January 4, 2013
Estimated Study Completion Date: October 1, 2032
Estimated Primary Completion Date: October 1, 2032 (Final data collection date for primary outcome measure)
Detailed Description:

Asthma is a common disease and a significant public health problem, affecting one in every 10 individuals, nearly 30 million people in the US alone. About 5-10% of asthmatics have severe disease that is difficult to control with standard therapies. Severe asthmatics are considered to be relatively resistant to corticosteroids, a mainstay of therapy in asthma. Furthermore, chronic corticosteroid therapy often results in side effects that adversely affect outcomes. Thus, more effective treatment options, which are safe, cost-effective and easy to administer, are needed for severe asthmatics.

As our understanding of asthma evolves, it is becoming clearer that there are distinct phenotypes that differ regarding demographic factors such as age, sex and race, but also, perhaps more importantly, with regards to clinical, physiologic and biologic characteristics. This heterogeneity may reflect distinct pathogenic mechanisms that result in airflow obstruction and the clinical presentation of asthma. In turn, a better understanding of the different factors that contribute to disease severity and pathogenesis will be necessary to identify new, personalized treatment and management approaches for severe asthmatics. Our goal is to gain a better understanding of the pathogenic mechanisms that differentiate severe asthma from mild to moderate asthma, including the role of the above-mentioned factors on disease control. In so doing, we hope to discover novel pathways that can be manipulated to achieve our primary aim of developing new therapies for severe asthmatics.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
  • All volunteer subjects must be at least 18 years of age and must be able to provide informed, written consent for participation in this study. Subjects will be recruited irrespective of age, sex, race or ethnicity. Eligibility in the study is determined on the basis of the following inclusion and exclusion criteria.


  • Subjects must be over 18 years of age.
  • Subjects must have had a diagnosis of asthma, as defined by the American Thoracic Society, for at least one year to enter this study.
  • Subjects must have a history of reversible airflow obstruction, as defined by a positive response to inhaled bronchodilators or a positive methacholine bronchoprovocation challenge by ATS criteria. Severe, refractory asthma will be defined by the 2000 ATS workshop consensus criteria. Refractory asthmatics will meet one or both of the major criteria and at least two minor criteria as outlined in Table 1.This definition is applicable only to patients in whom other conditions have been excluded, exacerbating factors have been optimally treated, and poor adherence does not appear to be a confounding issue . Compliance or medication adherence will be assessed at the initial and subsequent visits by questioning the subjects about their medication use (self-report).
  • If asthmatic subjects do not fulfill the criteria for severe asthma, they will be classified as mild to moderate asthmatics.
  • Subjects must have the ability to provide informed consent.


  • Subjects must be at least 18 years of age without a clinical diagnosis of asthma.
  • Subjects must have no evidence of obstructive airway disease, as defined by ATS criteria on spirometry, and a negative methacholine bronchoprovocation challenge.
  • Subjects must have the ability to provide informed consent.
  • Subjects will be matched to asthmatics by gender and age (+/- 10 years).


-Any concurrent condition (medical, social or behavioral) that, in the opinion of the research team, would preclude or confound acquisition or interpretation of data or delivery of care.

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01780142

Contact: Rosemarie A Cuento, C.R.N.P. (301) 451-9284
Contact: Amisha V Barochia, M.D. (301) 443-7790

United States, Maryland
National Institutes of Health Clinical Center, 9000 Rockville Pike Recruiting
Bethesda, Maryland, United States, 20892
Contact: For more information at the NIH Clinical Center contact Patient Recruitment and Public Liaison Office (PRPL)    800-411-1222 ext TTY8664111010   
Sponsors and Collaborators
National Heart, Lung, and Blood Institute (NHLBI)
Principal Investigator: Amisha V Barochia, M.D. National Heart, Lung, and Blood Institute (NHLBI)
  More Information

Additional Information:
Responsible Party: National Heart, Lung, and Blood Institute (NHLBI) Identifier: NCT01780142     History of Changes
Other Study ID Numbers: 130059
Study First Received: January 29, 2013
Last Updated: April 20, 2017

Keywords provided by National Institutes of Health Clinical Center (CC):
Airflow Obstruction
Airflow Inflammation
Corticosteroid Resistance
Quality of Life

Additional relevant MeSH terms:
Bronchial Diseases
Respiratory Tract Diseases
Lung Diseases, Obstructive
Lung Diseases
Respiratory Hypersensitivity
Hypersensitivity, Immediate
Immune System Diseases processed this record on April 24, 2017