RT Journal文章SR电子T1哮喘按照Arg16Gly Beta-2基因型：在青少年的随机试验JF欧洲呼吸杂志Jo EUR Respir J FD欧洲呼吸学会SP 2004107 Do 10.1183 / 13993003.04107-2020 A1 Ruffles，Tom A1 Jones，Christina J188bet官网地址A1 Palmer，Colin A1 Turner，Steve A1 Grigg，Jonathan A1 Hogarth，Fiona A1 Rauchhaus，Petra A1 Pilchhaus，Kristina A1 Hannah，Romanie A1 Smith，Helen A1 Littleford，Roberta A1 Lipworth，Brian A1 Mukhopadhyay，Somnath YR 2021UL //www.qdcxjkg.com/content/early/2021/01/14/13993003.04107-2020.Abstract Ab简介β-2（β2）肾上腺菌中rs1042713（Arg16氨基酸）的等位基因与对具有哮喘的年轻人的长效β2激动剂（Laba）的反应不佳。我们的目的是评估根据Arg16gly基因型的Laba或白三烯受体拮抗剂（LTRA）的第二线控制器是否会导致儿科哮喘相关的生命质量调查问卷（PAQLQ）。方法我们进行了务实的随机控制试验（RCT）通过覆盖英格兰和苏格兰的初级保健临床研究网络。我们注册了12-18岁的参与者，哮喘吸入皮质类固醇。共有241名参与者（平均（SD）年龄为14.7岁（1.91））被随机（1：1）接受个性化护理（基因型定向规定）或标准指南护理。在4周内参与者之后遵循12个月。PAQLQ的主要结果措施是变化的。 Asthma control, asthma exacerbation frequency and healthcare utilisation were secondary outcomes.Results Genotype directed prescribing resulted in an improvement in PAQLQ compared to standard care 0.16, (95%CI 0.00–0.31; p=0.049), although this improvement was below the pre-determined clinical threshold of 0.25. The AA genotype was associated with a larger improvement in PAQLQ with personalised versus standard care 0.42, (95%CI 0.02–0.81; p=0.041).Conclusion This is the first RCT demonstrating that genotype driven asthma prescribing is associated with a significant improvement in a clinical outcome compared to standard care. Adolescents with the AA homozygous genotype benefited most. The potential role of such β2-adrenoceptor genotype directed therapy in younger and more severe childhood asthma warrants further exploration.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Ruffles has nothing to disclose.Conflict of interest: Dr. Jones reports and The research was funded by children's charity Action Medical Research.Conflict of interest: Dr. Palmer has nothing to disclose.Conflict of interest: Dr. Turner reports and The research was funded by children's charity Action Medical Research.Conflict of interest: Dr. Grigg reports personal fees from AstraZeneca, personal fees from GSK, personal fees from Medimmune, personal fees from BV Pharma, during the conduct of the study;.Conflict of interest: Dr. Tavendale has nothing to disclose.Conflict of interest: Dr. Hogarth reports grants from University of Sussex, during the conduct of the study;.Conflict of interest: Ms. Rauchhaus has nothing to disclose.Conflict of interest: Ms Pilvinyte has nothing to disclose.Conflict of interest: Dr. Hannah has nothing to disclose.Conflict of interest: Dr. SMITH has nothing to disclose.Conflict of interest: Dr. Littleford reports grants from The Henry Smith Charity, grants from Action Medical Research, during the conduct of the study.Conflict of interest: Dr. Lipworth reports other from GSK, grants, personal fees and non-financial support from AstraZeneca, grants, personal fees and non-financial support from Chiesi, personal fees from Novartis, grants, personal fees and non-financial support from Boerhinger Inhgelheim, personal fees from Dr Reddys, personal fees from Sandoz, personal fees from Cipla, personal fees from Glenmark, grants, personal fees and non-financial support from Teva, during the conduct of the study; personal fees from Lupin, grants and personal fees from Sanofi Regeneron, personal fees from Vectura, outside the submitted work; and Son of BJL is employee of AstraZeneca.Conflict of interest: Dr. Mukhopadhyay has nothing to disclose.