Patient description: The patient is a 15-year-old boy with asthma diagnosed a year ago. He presents with shortness of breath, chest tightening and cough. According to his mother, he didn't respond to the usual corticosteroid inhaler. He was admitted to the emergency department with diagnosis of severe asthma exacerbation. He is a candidate for general corticosteroid therapy. Spirometry revealed a forced expiratory volume in the first second (FEV1) of 60% of the predicted. His past medical history is non-significant. His family history is significant for asthma in his mother and his uncle. He used to be treated with combination of inhaled corticosteroids and Zafirlukast.

Clinical trial eligibility criteria: eligible ages (years): 6.0-17.0,  Asthma Study applicant(s) that fulfill all of the and none of the are eligible for the study- Participant and/or parent guardian must be able to understand and provide informed consent and age-appropriate assent Must have a primary place of residence in one of the pre-selected recruitment census tracts as outlined in the study's Manual of Procedures (MOP) Has had a diagnosis of asthma made >1 year prior to recruitment; --Those who received an asthma diagnosis by a clinician ≤1 year prior to recruitment must report that their respiratory symptoms were present for more than 1 year prior to recruitment Has had ≥2 asthma exacerbations in the prior year (defined as a requirement for systemic corticosteroids and/or hospitalization) At Visit 0 (Screening), has the following requirement for asthma controller medication For those ages 6 to 11 years, treatments with at least fluticasone 250 mcg dry powder inhaler (DPI) one puff twice daily or its equivalent and For those ≥12 years of age, treatment with at least Advair 250/50 mcg dry powder inhaler (DPI), one puff twice daily or its equivalent Has peripheral blood eosinophils ≥150 cells/µl obtained at Visit 0 (Screening) or in another Inner-City Asthma Consortium (ICAC) clinical research study within 6 months Is able to perform spirometry at randomization (Visit for treatment assignment)  Individual(s) who meets any of the following are not eligible for enrollment or randomization- Is not able or willing to give written informed consent or comply with the study protocol Has concurrent (existing) medical problems that would require systemic corticosteroids or other immunomodulator treatments during the study Is currently receiving immunotherapy Is currently receiving treatment with omalizumab or has had omalizumab treatment within 6 months prior to planned participant randomization to treatment assignment Is currently requiring greater than fluticasone 500 mcg administered twice daily plus a long-acting beta agonist (LABA) one puff twice daily or its equivalent, and/or --Individuals using oral corticosteroids daily or every other day for more than 14 days at the time of Visit 0 (Screening) Is currently pregnant or lactating, or plans to become pregnant during the time of study participation --Note: Females of child-bearing potential (post-menarche) must be abstinent or use a medically acceptable birth control method throughout the study (e.g. oral subcutaneous, mechanical, or surgical contraception) Has a known, pre-existing clinically important lung condition other than asthma Has a current malignancy or previous history of cancer in remission for less than 12 months prior to randomization Has known, pre-existing, unstable liver disease