England’s National Institute for Health and Care Research (NIHR), University Hospital Southampton (UHS) and University Hospitals of Leicester NHS Trust have teamed up to conduct a multicenter clinical trial to determine the most effective emergency treatment for children and young people suffering from life-threatening asthma attacks. All three entities indicated in a press release they are hopeful the trial will reshape national healthcare guidelines.
The study, Evaluation of Intravenous Therapy in Asthma (EVITA), compares three commonly used hospital treatments — aminophylline, magnesium sulphate and salbutamol — to establish which offers the best outcomes for patients.
The trial began in fall 2025 and will continue to follow 357 patients ages two to 18 from hospitals across the United Kingdom, including Leicester, Southampton, Liverpool and Edinburgh. Additional hospitals are expected to join, expanding the study’s reach and ensuring diverse patient representation.
Despite the seriousness of pediatric asthma, clinicians currently rely on three intravenous medications — but there are limited data to determine which one works best.
“At the moment, doctors have three options but very little evidence to guide which one works best for each child,” said Katrina Cathie, MBE, a consultant pediatrician and EVITA co-lead, said in a UHS press release. “This leads to variation in practice across the U.K. and around the globe.”
According to trial investigators, children admitted to emergency departments with severe asthma attacks are randomly assigned to receive one of the three treatments:
- Aminophylline
- Magnesium sulphate
- Salbutamol
All three medications help by relaxing airway muscles and improving airflow, they said, but their comparative effectiveness, side effects and patient experience differ.
EVITA researchers are tracking several outcomes, including:
- Speed of symptom improvement
- Length of hospital stay
- Side effects
- Treatment costs
- Acceptability to patients, families and healthcare providers
This comprehensive approach aims to identify not just the most effective drug, but also the most patient-friendly and cost-efficient option for the NHS, the researchers said.
“Getting treatments right for children with severe asthma attacks is absolutely critical,” said Graham Roberts, professor of pediatric allergy and respiratory medicine at the University of Southampton and co-lead of the trial. “These episodes can be life-threatening and require urgent, effective care.”
The NHS reports that asthma affects approximately one in 11 children in the U.K., making it the most common chronic condition in young people. Severe cases are a leading cause of emergency hospital admissions nationwide.
A unique feature of the EVITA trial, the study notes, is its focus on patient and family priorities. Before launching the study, researchers consulted families to understand what matters most.
“Children and their families told us that their child feeling better and looking well was the most important outcome,” said Damian Roland, pediatric emergency medicine consultant at the University Hospitals of Leicester NHS Trust and trial co-lead.
Roland said this feedback shaped the trial design, ensuring that clinical success is measured not only by medical metrics but also by real-world patient experience.
Researchers said the findings from EVITA could have far-reaching implications, directly informing national clinical guidelines, helping standardize care across the U.K. and potentially influencing global practices.
Key expected benefits include:
- Faster, more effective treatment for children
- Reduced hospital stays
- Fewer side effects
- Better use of NHS resources
“We hope our results will help to standardize asthma treatment in the U.K.,” said Roland,
“ensuring children receive the fastest, most appropriate and best possible care.
