BEST ADD-ON THERAPY GIVING EFFECTIVE RESPONSES (BADGER)

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The main purpose of this study is to answer this question: What is the best way to improve asthma control in children who are not controlled on low-dose inhaled corticosteroids? Increase the dose of inhaled corticosteroid? Or, keep the inhaled corticosteroid dose the same and add another medication [long acting beta-agonist (e.g. salmeterol) or a leukotriene receptor antagonist (e.g. (Singulair¿¿)]? To answer this question, subjects will take each one of these three medication options, along with your daily inhaled corticosteroid, at different times throughout the study. Flovent Diskus¿¿ is the inhaled corticosteroid that will be used in this study. It is approved by the Food and Drug Administration (FDA) for asthma in adults and children age 4 years and older at the dose used in this study. Singulair¿¿ is the leukotriene receptor antagonist (tablet) that will be used in this study. It is approved by the FDA for asthma in adults and children age 6 years and older at the dose used in this study. Advair Diskus¿¿, which contains a long-acting beta-agonist (salmeterol) and an inhaled corticosteroid (same type as found in Flovent Diskus¿¿), will be used for this study. It is FDA approved for asthma in adults and children age 4 years and older. Another purpose of the research study is to determine what body features, including a participant¿??s genes, may be linked with either a good or poor response to each of these asthma medications. A blood sample will be taken during the randomization visit (V2a) to help look for these features. These findings may increase our understanding of the possible link between asthma and allergies and whether an individual will or will not respond to an asthma medication. A genetic analysis is required to participate in this study. Approximately 36 subjects will be enrolling in this study at National Jewish. A total of 180 subjects will be participating in the study at 5 different sites across the United States.