ERS 2020 — Genotype-based prescribing beneficial for older children with asthma


  • Pavankumar Kamat
  • Actualités des congrès
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Takeaway

  • Personalizing controller treatments according to the genetic differences could be beneficial for children aged 12-18 years with asthma.

Why this matters

  • The A allele of rs1042713 is associated with poor response in young individuals with asthma treated with inhaled corticosteroids (ICS) and long-acting ß2-agonist (LABA).

Study design

  • PACT: 241 children aged 12-18 years treated for asthma with ICS were randomly assigned (1:1) to receive either personalized care (rs1042713 genotype-based prescribing) or standard care (as per British Thoracic Society guidelines). 
  • The personalized care group was prescribed controller drugs based on rs1042713 genotype, with AA and AG genotypes receiving leukotriene receptor antagonist and GG receiving LABA. 
  • Primary outcome was change in Pediatric Asthma Quality of Life Questionnaire (PAQLQ) at 12 months.
  • Funding: None disclosed.

Key results

  • The personalized care group showed a significant improvement in mean PAQLQ compared with standard care (0.16, 95% CI, 0.00-0.31; P=.049), but the difference was below the clinical threshold (0.25).
  • Individuals with homozygous AA genotype demonstrated the greatest improvement in mean PAQLQ with personalized care vs standard care (0.42, 95% CI, 0.02-0.813; P=.041), which exceeded the clinical threshold. 

Limitations

  • Younger children (

Expert commentary

Professor Somnath Mukhopadhyay, who led the study said in a press release: "These results are very promising because they show, for the first time, that it could be beneficial to test for certain genetic differences in children with asthma and select medication according to those differences."