By ANNE CHRISTIANSEN-BULLERS
KANSAS CITY - The struggle to breathe is well-documented symptom for those battling COVID-19, so how is the disease best treated for those with existing respiratory problems, such as asthma?
A study to address that question, along with other research related to lung issues, is being supported by the American Lung Association and its research arm, the Airways Clinical Research Centers Network (ACRC).
The University of Kansas Medical Center recently expanded its position in the ACRC from member to consortium hub, which gives KU Medical Center the responsibility to mentor and lead other universities in its group.
Importance of ACRC Network
Mario Castro, MD, MPH, division chief for pulmonary, critical care and sleep medicine at the University of Kansas Medical Center, will act as principal investigator. He brings this role with him from a previous position at Washington University in St. Louis, Missouri.
The ACRC is the nation's largest not-for-profit network of clinical research centers focused on lung disease. Its member centers have advanced research in asthma and chronic obstructive pulmonary disease (COPD).
"The ACRC Network is an incredibly valuable resource in pulmonology research," Castro said. "The network has answered some of the most important clinical questions we need to manage our patients with asthma, COPD and chronic cough. Now we are leveraging this expertise to tackle the COVID-19 pandemic."
COVID-19 Action Initiative
KU Medical Center will be one of nine hub leaders for the ACRC's COVID-19 Action Initiative, a $25 million project from the American Lung Association. The initiative's goals are to:
- Expand respiratory research
- Fund grants for coronavirus vaccines and other prevention measures
- Provide additional grants for research evaluating the effects of COVID-19 on patients with chronic lung disease
- Enhance key public health measures through education and advocacy
American Lung Association President and CEO Harold Wimmer said the COVID-19 pandemic exemplifies the importance of ongoing lung disease research championed by the ACRC. "Clinical research allows us to advance scientific knowledge from the lab to the patient's bedside swiftly, directly impacting patient care," he said.
Millennial Lung Health Cohort Study
A second major ACRC initiative, the Lung Health Cohort Study of millennials (ages 25-35 years old), will examine the effect of environmental exposures on respiratory health in young people. These environmental exposures will include urgent, timely and relevant factors, such as COVID-19 and vaping.
Castro said KU Medical Center is honored to play a role in the initiative, which is funded by a $24.8 million grant from the National Institutes of Health.
"Often, when we think of breathing problems, we focus on the very young or the very old," Castro said. "The Lung Health Cohort Study provides an opportunity to research exposure risk within a young person's environment, so that all generations can benefit moving forward."
Clinical trial for those with asthma
"We hypothesize that the telehealth visits will reduce asthma attacks and lead to better medication adherence."
Locally, KU Medical Center is teaming up with Children's Mercy Kansas City for a clinical trial to be conducted by the ACRC. The trial, called "Improving Medication Adherence with Telehealthcare Medication Therapy Management to Change Health Outcomes in Adolescents and Young Adults with Asthma," goes by the acronym MATCH and is funded by the National Institutes of Health.
Participants will include 300 adolescents and young adults (ages 14-30) who have a difficult time controlling their asthma.
All participants in the clinical trial will receive sensors that attach to their corticosteroid inhalers and a software application for their smartphone or computer.
When the medication is taken, the sensors relay information to the software so the clinical trial participant and the trial administrator can review it. With that data, both can see how well the participant is sticking to the medication plan.
Some participants will get extra support to adhere to their medication plan. In addition to the sensors and software, these participants will have video consultations with a pharmacist trained in medication therapy management. These telehealth visits will offer the participant periodic feedback and encouragement.
The clinical trial will measure which group has fewer asthma flare-ups. It also will figure out the cost-benefit analysis of the telehealth consultations.
"We hypothesize that the telehealth visits will reduce asthma attacks and lead to better medication adherence," Castro said. "Being able to test that hypothesis as well as measure its costs - especially against the costs associated with an emergency-room visit or hospitalization - could provide insight into a new approach to this common chronic disease, especially in these days of the pandemic where telehealth provides definite advantages to patient care."
About the ACRC expansion
In April 2020, the number of member institutions within ACRC nearly doubled, from 22 sites to 39. Universities within the current KU Medical Center consortium hub include the university itself as well as:
- Vanderbilt University
- University of Wisconsin-Madison
- Wake Forest School of Medicine, Winston-Salem, North Carolina
"As our nation faces the COVID-19 public health crisis, this framework of the ACRC is needed today more than ever," ALA's Wimmer said.