New Trial Compares IV Treatments for Severe Asthma in Kids

Monash University

A clinical trial to determine the best intravenous (IV) treatments for children with severe asthma will go ahead thanks to an almost $5 million Medical Research Future Fund grant.

The clinical trial - spearheaded by Professor Simon Craig, Adjunct Clinical Professor in the School of Clinical Sciences at Monash Health and paediatric emergency medicine physician at Monash Medical Centre - will provide clinicians with clear evidence to make more informed decisions, provide faster and more effective treatment, reduce unnecessary variation between hospitals, and ultimately improve outcomes for children with severe asthma.

"Asthma is one of the most common reasons children come to emergency departments across Australia. Most children improve with standard treatments such as inhaled salbutamol and oral steroids, but a small group remain very unwell and are at risk of needing intensive care. For these children, doctors often use 'second-line' medicines given through a vein to help open the airways," Professor Craig said.

"The two most commonly used options in Australia are IV magnesium and IV aminophylline; however, we don't know which one works better. Practice varies between hospitals, and decisions are often based on tradition rather than strong evidence. Because both medicines have potential benefits and risks, families and clinicians need clear evidence to guide decisions."

This randomised controlled trial will directly compare the two treatments in children who need extra help beyond standard care.

The research team aims to compare the two treatments in over 1,000 children aged from two to 15 years with acute asthma, across 18 hospitals throughout Australia and New Zealand, all part of the PREDICT network.

"By measuring how quickly children improve, how long they stay in hospital, how often they need admission to intensive care, and what side effects occur, the study will provide the first strong, head-to-head evidence about which medicine gives the best balance of benefit and safety," Professor Craig said.

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