Public Release: 

New research on preventing fall asthma exacerbations

Published in The Journal of Allergy and Clinical Immunology

Children's Hospital Colorado


IMAGE: Dr. Stanley Szefler with a patient at Children's Hospital Colorado. view more

Credit: Children's Hospital Colorado

Aurora, Colo. (Jan. 14, 2016) - Experts from Children's Hospital Colorado (Children's Colorado) co-led a team of researchers in studying new approaches to reducing fall asthma exacerbations in pediatric patients. Their findings were released online in late October and published in the December 2015 issue of The Journal of Allergy and Clinical Immunology (JACI), an official scientific journal of the American Academy of Allergy, Asthma & Immunology (AAAAI) and the most-cited journal in the field of allergy and clinical immunology.

Known as the PROSE (Preventative Omalizumab or Step-Up Therapy for Fall Exacerbations) Trial, the study looked at whether or not a preventative strategy of treating patients with omalizumab (Xolair) four to six weeks before the start of school and continuing it for the next four months helped prevent the asthma flare-ups that typically come during the fall season when children return to school, a time known as the September Epidemic of Asthma.

Designed by Stanley J. Szefler, MD, Director of the Pediatric Asthma Research Program and Research Medical Director of the Breathing Institute at Children's Colorado, the study was led by Stephen J. Teach, MD, Chair of the Department of Pediatrics at Children's National Health System. Andrew Liu, MD, allergist and immunologist at Children's Colorado, was the site manager for the Colorado portion of the study.

The study included 727 participants, ages six to 17 years, who resided in low-income, inner-city areas. It was conducted over two fall cycles, 2012 and 2013. Participants received interventions beyond their regular ongoing treatment beginning four to six weeks prior to the beginning of school and ending 90 days following the start of school.

Study findings indicate that preventative treatment with omalizumab does reduce fall exacerbations in a high-risk group of allergic asthma subjects. This effect was seen most notably in participants who had experienced a recent exacerbation.

The therapy also appears to restore immune protection against common cold viruses that can trigger severe asthma attacks and can be impaired by allergies.

"The results of our study give us an exciting new way to treat pediatric patients with allergic asthma," said Dr. Szefler. "By identifying those patients who are at high risk for fall asthma exacerbations, we can target directed treatment for them during the times of year that they're at the greatest risk for problems. In this way, we can better control their asthma and hopefully ultimately limit their treatment duration."

The researchers also found that increasing inhaled steroid treatment levels above those determined to achieve control offered little to no additional benefit in preventing exacerbations.


About Children's Hospital Colorado

Children's Hospital Colorado (Children's Colorado) has defined and delivered pediatric health care excellence for more than 100 years. Founded in 1908, Children's Colorado is a leading pediatric network entirely devoted to the health and well-being of children. Continually acknowledged as one of the nation's outstanding pediatric hospitals by U.S. News & World Report and ranked 5th on its Best Children's Hospitals 2015-16 Honor Roll, Children's Colorado is known for both its nationally and internationally recognized medical, research, education and advocacy programs, as well as comprehensive everyday care for kids throughout Colorado and surrounding states. Children's Colorado is the winner of the 2015 American Hospital Association-McKesson Quest for Quality Prize, and is a 2015 Most Wired hospital according to Hospitals & Health Networks magazine. Children's Colorado also is recognized for excellence in nursing from the American Nurses Credentialing Centers and has been designated a Magnet® hospital since 2005. The hospital's family-centered, collaborative approach combines the nation's top pediatric doctors, nurses and researchers to pioneer new approaches to pediatric medicine. With urgent, emergency and specialty care locations throughout Metro Denver and Southern Colorado, including its campus on the Anschutz Medical Campus, Children's Colorado provides a full spectrum of pediatric specialties. For more information, visit and connect with Children's Colorado on Facebook, Twitter and Pinterest.

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