Understanding the Asthma Research Landscape in America
Asthma does not look the same in every patient. Some people have allergic asthma triggered by pollen or pet dander. Others deal with eosinophilic asthma, a subtype driven by high levels of a specific white blood cell. Then there is exercise-induced bronchoconstriction, occupational asthma, and a growing number of cases that overlap with COPD — a group researchers now refer to as asthma-COPD overlap. Each subtype responds differently to treatment, which is why clinical trials are rarely one-size-fits-all.
The U.S. clinical research infrastructure is broad. Trials are run by academic medical centers like the University of Michigan and Duke University, by pharmaceutical companies testing new biologic drugs, and by federal agencies including the National Institutes of Health. The American Lung Association also maintains its own network of Airways Clinical Research Centers (ACRCs) that conduct investigator-initiated studies across the country.
A persistent concern in this field is representation. A cross-sectional analysis published in 2025 found that only about a third of asthma trials reported using structured recruitment strategies aimed at diversity. Black and Hispanic populations in the U.S. have higher rates of asthma-related emergency department visits and hospitalizations, yet they are frequently underrepresented in the studies that shape treatment guidelines. The recent PASSAGE study — a Phase 4 real-world trial of tezepelumab presented at the 2026 ATS International Conference — specifically enrolled Black/African American patients, adolescents, smokers, and individuals with overlapping asthma and COPD to help close that evidence gap. Results showed significant reductions in exacerbations across all groups, reinforcing why inclusive enrollment matters.
What a Clinical Trial Actually Involves
Walking into a clinical trial can feel intimidating if you do not know what to expect. The process is structured in phases, each with a distinct purpose.
Phase 1 studies are the earliest stage. They typically involve a small group of participants — sometimes healthy volunteers, sometimes people with asthma — and focus on safety, dosage, and how the body processes the drug. These are the trials that tend to offer higher compensation for time and travel, given the level of monitoring involved.
Phase 2 trials expand the pool and zero in on effectiveness. Researchers are trying to answer whether the treatment actually improves asthma control, measured through outcomes like forced expiratory volume (FEV1), asthma control questionnaires, and exacerbation rates. If you have moderate persistent asthma that is not fully controlled on inhaled corticosteroids, Phase 2 is often where you would fit.
Phase 3 trials are large, often international, and compare the investigational treatment to either a placebo or the current standard of care. These are the pivotal studies that regulatory agencies review when deciding whether to approve a drug. For participants, Phase 3 means more visits, longer commitment, and the possibility — though not the guarantee — of receiving the active treatment. Many Phase 3 asthma trials are double-blind, meaning neither the participant nor the study team knows who is getting the experimental drug.
Phase 4, also called post-marketing surveillance, happens after a treatment is already approved. These studies gather real-world data on long-term safety, effectiveness in broader populations, and how the therapy performs outside the tightly controlled environment of earlier phases. The PASSAGE study mentioned earlier is an example of this.
During any phase, participants can expect regular clinic visits that include breathing tests (spirometry), blood draws, physical exams, and questionnaires about symptoms and quality of life. Some trials also ask participants to keep a daily diary of peak flow readings and rescue inhaler use. The study team provides the equipment and training. A crucial point often overlooked: you can withdraw from a trial at any time, for any reason, without penalty.
| Trial Phase | Typical Duration | Compensation Range | Key Focus | Best Suited For |
|---|
| Phase 1 | Weeks to months | $1,000–$10,000+ | Safety and dosing | Healthy volunteers or mild asthma patients comfortable with intensive monitoring |
| Phase 2 | Several months | $500–$5,000 | Effectiveness signals | Moderate uncontrolled asthma patients seeking new options |
| Phase 3 | 6 months to 2+ years | $100–$2,000 | Confirmatory efficacy and safety | Broad patient populations; larger time commitment required |
| Phase 4 | Variable | $50–$500 | Real-world long-term data | Patients interested in post-approval research participation |
Compensation varies significantly by phase, study length, and the number of visits required. Some trials also reimburse travel costs and provide study-related medical evaluations at no charge. It is worth asking about these details during the screening call.
Finding Trials and Assessing Fit
The starting point for most people is ClinicalTrials.gov, a database maintained by the National Library of Medicine. The site lists tens of thousands of active studies and allows you to filter by condition ("asthma"), recruitment status ("recruiting" or "not yet recruiting"), location (by ZIP code and radius), and study phase. Typing in a specific subtype like "eosinophilic asthma" or "severe asthma biologic" can narrow results considerably.
The American Lung Association's clinical trial finder is another resource, particularly for studies run through the ALA-ACRC network. These tend to focus on practical questions relevant to everyday asthma management rather than early-stage drug development. Local academic hospitals — think pulmonary divisions at UCLA, Johns Hopkins, or the Cleveland Clinic — often list their actively recruiting asthma studies directly on their websites.
When evaluating a trial, a few questions help clarify whether it is the right fit:
One, what is the time commitment? Some studies require weekly visits for the first month, then taper to monthly. Others may only need quarterly check-ins. Be realistic about what your schedule can accommodate.
Two, what happens to your current medications? Most trials do not ask participants to stop all existing treatments. Instead, the investigational therapy is added on top of a stable controller regimen. The informed consent document will spell out exactly what is expected. Read it carefully.
Three, what are the known risks? The research team is required to discuss potential side effects, both from preclinical data and from earlier-phase human studies. For biologic therapies targeting immune pathways, for instance, there may be a slightly elevated risk of certain infections. These risks are weighed against the potential benefit of better asthma control.
Four, who is running the study? Trials affiliated with established academic centers or major health systems tend to have more oversight and infrastructure. This does not mean smaller or private research sites are unsafe — all clinical trials in the U.S. must be approved by an Institutional Review Board (IRB) — but it is worth knowing who is behind the research.
Elaine, a woman in her sixties who has lived with brittle asthma for more than half her life, joined a trial after decades of struggling with uncontrolled symptoms. "This is why I will go on to the trials and try anything, just to make myself better and help other people as well," she told researchers. After participating, she noticed a tangible shift: she could walk to the end of her street without losing her breath, something that had been out of reach before.
Practical Steps to Get Started
Begin by talking with your current pulmonologist or allergist. Many specialists are aware of trials recruiting in their region and can offer an informed perspective on whether a particular study makes sense for your asthma subtype and treatment history. Some practices even have research coordinators on staff who can pre-screen patients.
If you are searching on your own, use ClinicalTrials.gov with your ZIP code and a radius of 50 to 100 miles. For people in major metro areas — New York, Chicago, Houston, Los Angeles — there are often dozens of actively recruiting asthma studies at any given time. Those in rural areas may need to expand the radius or consider trials that offer telehealth components, which have become more common since 2020.
When you identify a study that looks promising, reach out to the contact listed on the trial page. This is typically a research coordinator who will ask a series of screening questions over the phone: your age, asthma diagnosis date, current medications, exacerbation history, and whether you have any other significant health conditions. This pre-screening call is informal and does not commit you to anything. If you pass the initial screen, you will be invited for an in-person screening visit where the study team performs more detailed assessments — blood work, spirometry, and sometimes allergy testing — to confirm eligibility.
The informed consent process happens before any study procedures begin. Take the document home if you need to. Ask a family member to read it. Write down questions. The team expects this and a good coordinator will welcome it.
For parents considering trials for children with asthma, the considerations are different. Pediatric asthma trials tend to be more conservative in design, often testing treatments already studied in adults. Parental consent and the child's assent (when age-appropriate) are both required. Visits may be scheduled around school hours, and many pediatric sites have child life specialists who help reduce anxiety around procedures like blood draws.
What the Current Trial Landscape Looks Like
The asthma research pipeline in 2026 is active, particularly in the biologic space. Following the FDA approval of depemokimab (brand name EXDENSUR) in late 2025 for severe eosinophilic asthma, attention has turned to long-acting biologics that require dosing only twice a year rather than monthly or biweekly. Several ongoing Phase 3 and Phase 4 trials are evaluating these extended-interval therapies, which could significantly reduce the treatment burden for patients who currently visit infusion centers or self-inject on a frequent schedule.
Another area of investigation involves biomarkers that predict treatment response. Researchers are studying whether exhaled nitric oxide levels, blood eosinophil counts, and other measures can identify which patients will benefit most from a given biologic before they start it. This kind of personalized approach could spare patients from trial-and-error cycles that sometimes stretch over years.
For those with milder asthma or exercise-induced symptoms, the focus is different. Trials are examining whether intermittent dosing of inhaled corticosteroids — taken only when symptoms flare rather than daily — can maintain control while reducing cumulative steroid exposure. This matters because long-term steroid use, even inhaled, is associated with small but real risks including decreased bone density and adrenal suppression.
Moving Forward
Deciding to join a clinical trial is a personal calculation. It involves weighing the inconvenience of extra appointments against the possibility of better symptom control. It means accepting uncertainty — the treatment might not work, or you might receive a placebo — in exchange for contributing to knowledge that helps others down the line.
The practical starting point is straightforward: search the databases, talk to your doctor, make a screening call. There is no obligation until you sign the consent form, and even then, the door to withdraw remains open. Asthma research depends on people willing to step forward, and the studies enrolling today are laying the groundwork for the treatments that will be standard practice in the years ahead.
To find current asthma clinical trials recruiting near you, visit ClinicalTrials.gov and enter "asthma" in the condition field along with your location. The American Lung Association's trial finder at lung.org offers an alternative search path, particularly for studies within the ALA-ACRC network. Both resources are free to use and updated continuously as new studies open enrollment.
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