Contact information
Type
Scientific
Contact name
Prof Jonathan Grigg
ORCID ID
Contact details
Institute of Cell and Molecular Science
Queen Mary University London
Academic Unit of Paediatrics
4 Newark Street
London
E1 2AT
United Kingdom
+44 (0)20 7882 2206
j.grigg@qmul.ac.uk
Additional identifiers
EudraCT/CTIS number
2004-005124-40
IRAS number
ClinicalTrials.gov number
Protocol/serial number
Asthma UK Funded Project ID 04/039; EudraCT Number: 2004-005124-40
Study information
Scientific title
Acronym
TWICS (Treatment of Wheeze In Children with Steroids)
Study hypothesis
The outcome for preschool children (10 months to 60 months) admitted to the hospital with an attack of wheeze triggered by clinical viral infection (preschool viral wheeze) and treated with oral steroids will be no different than those children treated with placebo (primary null hypothesis).
Secondary (null) hypotheses are that compared with oral placebo, treatment of hospitalised children with preschool viral wheeze with oral prednisolone will not:
1. Reduce the severity of respiratory distress at 4, 12, and 24 hours
2. Reduce the total severity of the attack, or the total amount of inhaled bronchodilators
3. Reduce the risk of significant hypoxia or re-admission within 4 weeks
Ethics approval(s)
1. Fife and Forth Valley Local Research Ethics Committee (MREC ref: 05/S0501/7)
2. Leicestershire Local Research Ethics Committee Two (LREC ref: 05/Q2502/19)
3. Medicines and Healthcare products Regulatory Agency (MHRA) (CTA Number 23071/0001/001-0001)
Study design
Two-centre, three-hospital, randomised, double-blind placebo-controlled trial.
Primary study design
Interventional
Secondary study design
Randomised controlled trial
Study setting(s)
Not specified
Study type
Treatment
Patient information sheet
Condition
Preschool wheeze: In children between 1 and 5 years the phenotype of 'asthma' is characterised by transient episodes of wheeze triggered by viral colds with no or few interval symptoms
Intervention
By double-blind, stratified (by centre) randomisation, children will receive either oral corticosteroids for 5 days or placebo along with inhaled bronchodilator therapy (frequency and mode of delivery device decided by the clinician). The dose of the oral corticosteroid, prednisolone will be 20 mg for 2 to 5 year olds and 10 mg for children under age of 2 years.
Intervention type
Drug
Pharmaceutical study type(s)
Phase
Not Specified
Drug/device/biological/vaccine name(s)
Prednisolone
Primary outcome measure
Length of stay in hospital, i.e. time from randomisation to discharge from the hospital which will be assessed in two ways: first when the child was felt fit to be discharged by a clinician and second when child was discharged home.
Secondary outcome measures
1. Median symptom score (Preschool Respiratory Assessment Measure [PRAM] score) and parental symptom score (mean 7 day)
2. Total use of inhaled bronchodilators during hospitalisation (from notes) and total for 7 days post discharge (from parental diary and clinical notes)
3. Complications:
3.1. Hypoxia
3.2. Pediatric Intensive Care Unit (PICU) admission
3.3. Readmission within 1 month and withdrawal from the study
Overall study start date
01/01/2005
Overall study end date
01/01/2008
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
1. Children aged 10 months to 60 months
2. Preceding history of a viral illness with upper respiratory tract symptoms/signs associated with an acute episode of physician diagnosed wheeze (preschool viral wheeze)
3. Who need admission to the hospital
Participant type(s)
Patient
Age group
Child
Lower age limit
10 Months
Upper age limit
60 Months
Sex
Both
Target number of participants
700
Participant exclusion criteria
1. Children < 10 months and > 60 months age
2. Fluid resuscitation (more than or equal to 20 ml/kg)
3. Bacterial sepsis (e.g. bacterial pneumonia, meningitis)
4. Cystic fibrosis, bronchiectasis and children with upper respiratory tract structural abnormality
5. Children on home oxygen
6. Diagnosis of immune deficiency
7. History of chronic persistent wheeze with no evidence of a discrete deterioration in association with a clinical cold
8. Active chicken pox
9. Children admitted for social reasons
Recruitment start date
01/01/2005
Recruitment end date
01/01/2008
Locations
Countries of recruitment
England, United Kingdom
Study participating centre
Institute of Cell and Molecular Science
London
E1 2AT
United Kingdom
Sponsor information
Organisation
Asthma UK
Sponsor details
Providence House
Providence Place
London
N1 0NT
United Kingdom
+44 (0)20 7226 2260
pmajor@asthma.org.uk
Sponsor type
Charity
Website
ROR
Funders
Funder type
Charity
Funder name
Asthma UK (Project ID 04/039)
Alternative name(s)
Asthma UK, Asthma + Lung UK
Funding Body Type
private sector organisation
Funding Body Subtype
Other non-profit organizations
Location
United Kingdom
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Individual participant data (IPD) sharing plan
IPD sharing plan summary
Not provided at time of registration
Study outputs
Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
---|---|---|---|---|---|
Results article | Results | 22/01/2009 | Yes | No |