Clinical trials for severe acute asthma in children need consistent outcome measures and large multi-centre studies

Monash University research demonstrates that large multi-centre studies with consistent outcome measures are needed to understand the management of acute severe asthma in children.  Read full story here

High-dose steroids don’t prevent asthma flare-ups

Professor Phil Bardin

High-doses of glucocorticoids are not effective in preventing life-threatening asthma exacerbations, according to a landmark study published in The New England Journal of Medicine last week.

Monash University’s Professor Phil Bardin was specially invited by the NEJM to assess the evidence for this therapy based on two recent asthma clinical trials.

“Inhaled glucocorticoids are pivotal to achieve asthma control in both children and adults but despite their use, many patients with asthma have flare-ups,” said Professor Bardin, Director Monash Lung & Sleep.

“Acute flares of asthma are detrimental because they adversely affect quality of life, lung function, and health care costs and have the potential to end in death.”

“Everyone agrees that preventing exacerbations is a priority in asthma care,” Professor Bardin said.

Professor Bardin said asthma specialists have long thought that more aggressive use of inhaled glucocorticoids can prevent exacerbations if initiated at the first signs of deterioration.

Professor Bardin found good evidence that children, in particular, receive no significant benefit from high-dose inhaled glucocorticoids in terms of their likelihood of having an asthma attack.

“The evidence indicates that substantial escalation of regularly used inhaled glucocorticoids, even by a factor of 4 or 5, fails to prevent most asthma exacerbations,” Professor Bardin said.

The editorial invitation by the prestigious journal is due to Professor Bardin and his team’s significant research into asthma at the Monash Health Translation Precinct (MHTP).

“The invitation to contribute to the NEJM on this topic is a testament to our global reputation built upon the outstanding clinical research done at Monash over many years,” Professor Bardin said.

“In particular, the Clinical Trials Unit in Monash Lung and Sleep, Monash Health under the leadership of Ms Joanne McKenzie has recently conducted ground-breaking research on monoclonal antibodies in asthma.”

This new treatment has had dramatic benefits for many patients with crippling severe asthma.

Increasing asthma inhaler strength does not prevent serious attacks and may stunt growth, study finds

Phil Bardin reported in The Independent.

Read article here.

Monash research brings hope to asthma, COPD and other patients with chronic inflammatory diseases

Professor Phil Bardin

Recently announced National Health and Medical Research Council (NHMRC) funding will enable Monash Health Translation Precinct researchers and clinicians to investigate new therapies for patients with asthma, chronic obstructive pulmonary disease (COPD) and other chronic inflammatory lung diseases.

Asthma and COPD are the most prevalent diseases of the respiratory system, and impose a significant burden on the Australian health care system. 

In addition to being a chronic burden, these diseases predispose affected individuals to frequent viral and bacterial infections, often requiring emergency department treatment.

The NHMRC-funded collaborative research project at Monash University, Monash Health and the Hudson Institute of Medical Research will investigate potential therapies to reduce the impact of virus infections in patients with COPD and asthma.

“Virus infections trigger asthma attacks, leading to lung deterioration and a gradual decline in lung function,” said lead researcher and Director, Monash Lung and Sleep, Professor Phil Bardin.

“People with asthma have increased levels of a molecule called transforming growth factor-beta (TGFB), and our team has previously shown that TGFB increases virus infection by suppressing the innate immune response, the body’s first line of defence.”

Professor Bardin’s project will determine the therapeutic potential of TGFB inhibitors that are already approved for use in humans as well as other novel compounds, to reduce the impact of virus infections in patients with COPD and asthma.

“Modulating TGFB levels may have a substantial impact in preventing organ dysfunction, improving quality of life and reducing the burden on the Australian health care system,” said Professor Bardin.

“Importantly, these findings are translatable to other chronic inflammatory conditions in which TGFB is over-expressed, including chronic lung diseases, as well as diseases involving the joints, liver, pancreas and kidneys.”

Professor Bardin said this research has the potential to significantly improve the quality of life of these patients, while reducing the burden of chronic diseases on the Australian Health Care system.”

Professor Bardin’s collaborators include Drs Belinda Thomas and Michael Gantier from the Hudson Institute of Medical Research, Monash University’s Professor Kate Loveland and Professor Jack Elias from Brown University, New York.