COVID-19 update

In response to COVID-19, we have paused patient recruitment into this study. We are continuing to follow-up people who are already taking part. It may be that we are in touch with you by a different method than usual (for example we may telephone you to complete questionnaires, rather than send them by post). If you have any questions about the study, please get in touch on 01224 438084 (and leave a message) or email. raaceno@abdn.ac.uk.

If you are a patient and require medical attention or advice, please contact your GP or NHS-111/NHS-24 (by dialling 111).

You can also find information about COVID-19 from the NHS websites in England ,Scotland, Wales and Northern Ireland.

There is also information about COVID-19 on the UK government website.

What is RAACENO?

RAACENO (pronounced "ra-chino") is a study that will investigate whether adding exhaled nitric oxide measurements to standard asthma care will help prevent asthma attacks in children. We all breathe out a gas called nitric oxide. We can measure exhaled nitric oxide using a special breathing device. People with asthma breathe out more nitric oxide than people without asthma because nitric oxide is produced by the allergic cells which are present in the lungs of people with asthma. We know that these allergic cells build up before an asthma attack. We now want to see whether adding exhaled nitric oxide measurements to standard asthma care will help prevent asthma attacks in children.

Can I take part?

We are recruiting patients at hospitals in the UK. You can see the location of these hospitals in the section of this website "where can I take part". Children and young people in the catchment area for these hospitals can take part if they

are aged 6-15 years,
have asthma,
are treated with inhaled corticosteroids,
have had an asthma attack treated with steroid tablets in the past year.

If you are interested in taking part, or have any questions

Royal Aberdeen Children's Hospital

Key people:

Investigator:

Dr Steve Turner

Address:

NHS Grampian
Foresterhill
Westburn Road
Aberdeen
AB25 2ZG

Tayside Children's Hospital

Key people:

Investigator:

Dr Jonathan McCormack

Address:

NHS TAYSIDE
MACH 2 Building
Level 4, Ninewells
Dundee
DD1 9SY

Royal Hospital for Children

Key people:

Investigator:

Dr James Paton

Address:

NHS Greater Glasgow and Clyde
1345 Govan Road
Govan
Glasgow
G51 4TF

Leicester Children’s Hospital

Key people:

Investigator:

Dr Erol Gaillard

Address:

University Hospitals of Leicester NHS Trust
Leicester Royal Infirmary
Leicester
LE1 5WW

Barnsley Hospital

Key people:

Investigator:

Dr Diamuid Kerrin

Address:

Barnsley Hospital NHS Foundation Trust
Gawber Road
Barnsley
S75 2EP

Sheffield Childrens Hospital

Key people:

Investigator:

Dr Sonal Kansra

Address:

Sheffield Childrens Hospital NHS Trust
Western Bank
Sheffield
S10 2TH

Royal Stoke University Hospital

Key people:

Investigator:

Dr Will Carroll

Address:

University Hospitals of North Midlands NHS Trust
Newcastle Road
Stoke-on-Trent
Staffordshire
ST4 6QG

New Cross Hospital

Key people:

Investigator:

Dr Sally Edwards

Address:

THE ROYAL WOLVERHAMPTON NHS TRUST
Wolverhampton Road
Wolverhampton
WV10 0QP

University Hospital Crosshouse

Key people:

Investigator:

Dr Timothy Adams

Address:

NHS Ayrshire & Arran
Kilmarnock Rd
Kilmarnock
KA2 0BE

Royal Devon and Exeter Hospital

Key people:

Investigator:

Dr Patrick Oades

Address:

Royal Devon and Exeter NHS Foundation Trust
Barrack Road
Exeter
EX2 5DW

Derriford Hospital

Key people:

Investigator:

Dr Denise Ullmann

Address:

Plymouth Hospitals NHS Trust
Derriford Road
Crownhill
Plymouth
PL6 8DH

Birmingham Children's Hospital

Key people:

Investigator:

Dr Priti Kenia

Address:

Birmingham Women’s and Children’s Hospital NHS Foundation Trust
Steelhouse Lane
Birmingham
B4 6NH

Nottingham Children's Hospital

Key people:

Investigator:

Dr Jayesh Bhatt

Address:

Nottingham University Hospitals NHS Trust
Queen's Medical Centre
Nottingham
NG7 2UH

Bradford Royal Infirmary

Key people:

Investigator:

Dr Anil Shenoy

Address:

Bradford Teaching Hospitals NHS Foundation Trust
Duckworth Lane
Bradford
BD9 6RJ

Southampton General Hospital

Key people:

Investigator:

Prof Graham Roberts

Address:

University Hospital Southampton NHS Foundation Trust
Tremona Road
Southampton
SO16 6YD

Royal Hospital for Sick Children

Key people:

Investigator:

Dr Kenneth Macleod

Address:

NHS Lothian
Sciennes Road
Edinburgh
EH9 1LF

Royal Derby Hospital

Key people:

Investigator:

Donna Traves

Address:

Derby Teaching Hospitals NHS Foundation Trust
Uttoxeter Road
Derby
DE22 3NE

Manor Hospital

Key people:

Investigator:

Dr Hesham Abdalla

Address:

Walsall Healthcare NHS Trust
Moat Road
Walsall
WS2 9PS

Bristol Royal Hospital for Children

Key people:

Investigator:

Dr Simon Langton-Hewer

Address:

University Hospitals Bristol NHS Foundation Trust
Upper Maudlin Street
Bristol
BS2 8AE

Leeds General Infirmary

Key people:

Investigator:

Dr Emma Guy

Address:

Leeds Teaching Hospitals West Yorkshire
Leeds General Infirmary
Great George Street
Leeds Teaching Hospitals West Yorkshire
LS1 3EX

King’s College Hospital

Key people:

Investigator:

Dr Atul Gupta

Address:

King's College Hospital NHS Foundation Trust
Denmark Hill
London
SE5 9RS

BARTS HEALTH NHS TRUST

Key people:

Investigator:

Dr Chinedu Nwokoro

Address:

Children's Clinical Research Facility
7th Floor, North Tower, Royal London Hospital
Whitechapel Road, Whitechapel
E1 1BB

Royal Victoria Infirmery

Key people:

Investigator:

Dr Matthew Thomas

Address:

Evelyn Thomson / Karen Allen
Great North Children's Hospital
Queen Victoria Road
Newcastle Upon Tyne
NE1 4LP

Alder Hey Children’s Hospital

Key people:

Investigator:

Dr Ian Sinha

Address:

Alder Hey Children’s NHS Foundation Trust
Alder Hey Children’s NHS Foundation Trust
Eaton Road
Liverpool
L12 2AP

Wythenshawe Hospital

Key people:

Investigator:

Dr Naveen Rao

Address:

Manchester University NHS Foundation Trust
Wythenshawe Hospital
Southmoor Road
Manchester
M23 9LT

St George's Hospital

Key people:

Investigator:

Dr Anuradha Shankar

Address:

St Goerge's University Hospitals NHS Foundation Trust
Paediatric Medicine Office, 4th Floor,
Blackshaw Road
London
SW17 0QT

Princess Royal Hospital

Key people:

Investigator:

Dr Kumar Sethuraman

Address:

The Shrewsbury and Telford Hospital NHS Trust
Admin Hub
Apley Castle
Telford
TF1 6TF

Royal Alexandra Children’s Hospital

Key people:

Investigator:

Dr Akshat Kapur

Address:

Brighton and Sussex University Hospital NHS Trust
Eastern Road
Brighton
BN2 5BE

Countess of Chester Hospital

Key people:

Investigator:

Dr Ravi Jayaram

Address:

Countess of Chester Hospital NHS Foundation Trust
Liverpool Rd,
Chester
CH2 1UL

Harrogate District Hospital

Key people:

Investigator:

Dr Alex Hardisty

Address:

Harrogate and District NHS Foundatioin Trust
Lancaster Park Road
Harrogate
HG2 7SX

Russel's Hall Hospital - coming soon

Key people:

Investigator:

Dr Sohail Nassir

Address:

The Dudley Group NHS Foundation Trust
Dudley
DY1 2HQ

Wishaw General Hospital

Key people:

Investigator:

Dr Carol Dryden

Address:

NHS Lanarkshire
Paediatric Department
Wishaw General Hospital
Wishaw

Royal Oldham Hospital

Key people:

Investigator:

Prakash Kamath

Address:

Pennine Acute Hospitals NHS Trust
Rochdale Road
Oldham
OL1 2JH

Royal Preston Hospital

Key people:

Investigator:

Dr Karnam Sugumar

Address:

Paediatrics
Sharoe Green Lane
Fulwood, Preston
PR2 9HT

Southport & Omskirk Hospital NHS Trust

Key people:

Investigator:

Dr Sharryn Gardner

Address:

Wirral University Teaching Hosptial NHS Trust

Key people:

Investigator:

Dr Sudeshna Bhowmik

Address:

Wirral University Hospital NHS Trust
Arrowe Park Hospital, Arrowe Park Road
Upton, Wirral
CH49 5PE

Peninsula Practice

Key people:

Investigator:

Dr Lindsey Crockett

Address:

Alderton Heath Centre, Mill Hoo
Alderton
Woodbridge
IP12 3DA

The Wickham Market Medical Centre

Key people:

Investigator:

Dr Will Elson

Address:

Chapel Lane
Wickham Market
Woodbridge
IP13 0SB

Little St John Street Surgery

Key people:

Investigator:

Dr Gary Taylor

Address:

7 Little St John's Street
Woodbridge
Suffolk
IP12 1EE

Hanscombe House

Key people:

Investigator:

Dr Funlayo Subair

Address:

52A St Andrew Street
Hertford
Hertfordshire
SG14 1JA

Parsonage Surgery

Key people:

Investigator:

Dr Jagjit Takhar

Address:

Herts And Essex Hospital
Cavell Drive
Bishop's Stortford, Hertfordshire
CM23 5JH

Portmill Surgery

Key people:

Investigator:

Dr Jehad Aldegather

Address:

114 Queen Street
Hitchin
Herts
SG4 9TH

Barrack Lane Medical Centre

Key people:

Investigator:

Dr Debasish Banerjee

Address:

1 Barrack Lane
Ipswich
IP1 3NQ

The Health Centre Practice (Royston)

Key people:

Investigator:

Dr Theresa Leighton

Address:

Melbourn Street
Royston
Hertfordshire
SG8 7BS

Oak Street Medical Practice

Key people:

Investigator:

Dr Salah Estifanos

Address:

Oak Street Medical Practice
1 Oak Street
NORWICH
NR3 3DL

Roundwell Medical Centre

Key people:

Investigator:

Chaminda Dooldeniya

Address:

The Primary Centre
25-27 Dr Torrens Way
Costessey, Norwich
NR5 0GB

West Pottergate Medical Centre

Key people:

Investigator:

Hugh Wilson

Address:

Earlham Road
Norwich
RN2 4BX

Wensum Valley Medical Practice

Key people:

Investigator:

Dr Clive Aiton

Address:

46 Earlham Centre West
Norwich
NR5 8AD

St Stephens Gate Medical Practice & Newmarket Road Surgery

Key people:

Investigator:

Dr Tim Bosworth

Address:

St Stephen's Gate Medical Practice
55 Wessex St
Norwich
NR2 2TJ

Ixworth Surgery - coming soon

Key people:

Investigator:

Dr Vijay Chandraraj

Address:

Peddars Close
Ixworth
Bury St Edmunds
IP31 2HD

Lakenham Surgery

Key people:

Investigator:

Dr Ochuko Emore

Address:

Norfolk Community Health and Care NHS Trust
1 Ninham Street
Norwich
Norfolk
NR1 3JJ

Castle Patnership

Key people:

Investigator:

Dr Joanna Walsh

Address:

40 Fishergate
Norwich
NR3 1SE

Lionwood Medical Practice

Key people:

Investigator:

Dr Jimmy Wang

Address:

30a Wellesley Avenue North
Norwich
NR1 4NU

Study news

Recruitment

515/502

Trial sites

Latest addition to sites:

                Oops
              
                            Lionwood Medical Practice
                        
                            Castle Patnership
                        
                            Lakenham Surgery
                        
                            St Stephens Gate Medical Practice & Newmarket Road Surgery
                        
                Oops

Key facts about the study and documents

We all have a gas called nitric oxide in the air we breathe out. People of all ages with asthma have more nitric oxide in their breath than people without asthma. Nitric oxide levels go up before and during an asthma attack and come back down after an attack. We can measure nitric oxide levels in breathed out air. In this study, we will investigate whether adding nitric oxide measurements to standard care for children with asthma can help reduce asthma attacks.

We will recruit 502 children aged 6-15 years with a diagnosis of asthma, who currently use inhaled corticosteroids, and who have had an asthma exacerbation in the previous 12 months.

We will randomise children to either:

A group that will have their asthma treatment guided by symptoms alone. This is standard care for children with asthma, where the doctor or nurse asks about how the child’s asthma has been, about any coughing or wheezing and how often they use their inhaler. At the first visit, based on this information, the child’s asthma treatment may stay the same or may be changed slightly. Children will be followed up at 3, 6, 9 and 12 months. At each visit, the doctor or nurse will ask about the child’s asthma symptoms, and their asthma treatment may stay the same or be changed slightly.
A group that will have their asthma treatment guided by nitric oxide levels plus symptoms. The doctor or nurse will ask about how the child’s asthma has been, about any coughing or wheezing and how often they use their inhaler. The doctor or nurse will also measure how much nitric oxide the child breathes out. At the first visit, based on this information, the child’s asthma treatment may stay the same or may be changed slightly. Children will be followed up at 3, 6, 9 and 12 months. At each visit, the doctor or nurse will ask about the child’s asthma symptoms and measure their levels of breathed out nitric oxide. Based on this, their asthma treatment may stay the same or be changed slightly.

All children taking part will have a meter on their inhaled steroid inhaler. This will allow the research team to know how much of the inhaler is being taken.

The primary outcome is asthma exacerbation (attack) which will be assessed at the 3, 6, 9 and 12 month follow-up visits, and confirmed with data held in medical records. Secondary outcomes include time to first exacerbation, number of exacerbations, and quality of life.

The study includes a health economic evaluation; data will be collected on asthma-related health care use, and time off school and away from other activities.

Around 200 children will also be invited to take part in optional mechanistic studies alongside the main study. The optional mechanistic studies involve:

spirometry after children have used their inhaler,
collection of sputum (coughed up spit) to count a type of white blood cell (eosinophil);
a skin prick test to determine reactivity (allergy) to common allergens; and
saliva collected for future DNA analysis.

Around 20 children will be invited to take part in an interview at the end of the 12 month follow-up to explore attitudes to, and acceptability of the FeNO measurements. Five research nurses will also be interviewed about the feasibility of FeNO measurements.

You can find out more information about RAACENO here:

The RAACENO study

SmartTouch installing and removing demonstration video

SmartTurbo installing and removing demonstration video

Download documents:

PIL - Parent (Primary care) (v4, 31 August 2017 )

PIL - Parent (Hospital) (Version 4, 31st August 2017)

PIL - Participant 12-15 years old (primary care) (v4, 31 August 2017)

PIL - Participant 12-15yrs (Hospital) (Version 4, 31st August 2017)

PIL - Participant 6-11yrs (Hospital) (Version 4, 31st August 2017)

SmartDisk installation guide (Version 1, 4th August 2017)

SmartTouch installation guide (Version 2, 25th January 2018)

SmartTurbo installation guide (Version 2, 24th January 2018)

Short PIL - hospital (v1, 31 March 2017)

Short PIL - Primary care (v1, 31 March 2017)

Short PIL (hospital ) PIC (v2, August 2-18)

Key contacts

Click on cards to find out more

Key questions & answers

Click on questions to find out more

                                            
                                                What is the purpose of the study?
                                            
                                                To see if asthma attacks can be reduced in children by measuring exhaled nitric oxide and using these measurements to help guide asthma treatment.
                                            
                                                What is nitric oxide?
                                            
                                                Nitric oxide is a gas that we all have in our breath and people with asthma breathe out more nitric oxide than people without asthma.   Nitric oxide does several jobs in our bodies including controlling the blood flow through blood vessels and helping our brains remember things. In addition to being a helpful thing, it is also produced by allergic cells rather like a car produces fumes. Nitric oxide does not smell, and we can't see it, but we can measure it.
                                            
                                                What do you expect to find?
                                            
                                                Our work leading up to this study suggests that using exhaled nitric oxide levels to help guide asthma treatment might reduce asthma attacks in children with asthma.  We are doing this study to find out whether this is the case or not.
                                            
                                                Who can take part?
                                            
                                                We will be asking children and young persons aged between 6 and 15 years to take part. They also need to be under the care of a hospital doctor for their asthma, to be on inhaled preventer medicine (called inhaled corticosteroids) and to have had an asthma attack treated with steroid tablets in the past year. We will be recruiting children in approximately 25 hospitals around the UK.
                                            
                                                How long will the study last?
                                            
                                                Children and young people taking part will be in the study for 12 months. The whole study will last 4 years.
                                            
                                                How might this change asthma care?
                                            
                                                If we find that asthma attacks are reduced with the help of the nitric oxide measurements we will recommend that all children with a recent asthma attack have nitric oxide testing. 
                                            
                                                What next?
                                            
                                                This all depends on what we find in this study. If we find that asthma attacks are reduced by using nitric oxide measurements to help guide treatment, we will do a similar study in children and young people in general practices to see if nitric oxide can reduce asthma attacks there too.

Organisation

This study was funded by the Efficacy and Mechanism Evaluation (EME) Programme of the National Institute for Health Research (NIHR). Please visit the NIHR website for more information: www.nihr.ac.uk.

General Data Protection Regulation (GDPR)
Participant Information

University of Aberdeen/NHS Grampian is the sponsor for this study based in the United Kingdom. We will be using information from you and your medical records in order to undertake this study and will act as the data controller for this study. This means that we are responsible for looking after your information and using it properly. University of Aberdeen/NHS Grampian will keep identifiable information about you at least 10 years after the study has finished.

Your rights to access, change or move your information are limited, as we need to manage your information in specific ways in order for the research to be reliable and accurate. If you withdraw from the study, we will keep the information about you that we have already obtained. To safeguard your rights, we will use the minimum personally-identifiable information possible.

You can find out more about how we use your information https://www.abdn.ac.uk/privacy.

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WELCOME TO RAACENO

Reducing Asthma Attacks in Children using Exhaled Nitric Oxide as a biomarker to inform treatment strategy - a randomised trial

COVID-19 update

What is RAACENO?

Can I take part?

If you are interested in taking part, or have any questions

Where can I take part?

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