TY - JOUR
T1 - Racial/Ethnic-Specific Differences in the Effects of Inhaled Corticosteroid Use on Bronchodilator Response in Patients With Asthma
AU - Samedy-Bates, Lesly Anne
AU - Oh, Sam S.
AU - Nuckton, Thomas J.
AU - Elhawary, Jennifer R.
AU - White, Marquitta
AU - Elliot, Tyronda
AU - Zeiger, Andy M.
AU - Eng, Celeste
AU - Salazar, Sandra
AU - LeNoir, Michael A.
AU - Meade, Kelley
AU - Farber, Harold J.
AU - Serebrisky, Denise
AU - Brigino-Buenaventura, Emerita
AU - Rodriguez-Cintron, William
AU - Bibbins-Domingo, Kirsten
AU - Kumar, Rajesh
AU - Thyne, Shannon
AU - Borrell, Luisa N.
AU - Rodriguez-Santana, José R.
AU - Pino-Yanes, Maria
AU - Burchard, Esteban G.
N1 - Funding Information:
This work was supported in part by the Sandler Family Foundation, the American Asthma Foundation, the RWJF Amos Medical Faculty Development Program, Harry Wm. and Diana V. Hind Distinguished Professor in Pharmaceutical Sciences II, National Institutes of Health R01HL117004, R01HL128439, R01HL135156, 1X01HL134589, and R01HL141992, National Institute of Environmental Health Sciences R01ES015794 and R21ES24844, the National Institute on Minority Health and Health Disparities P60MD006902 and R01MD010443, the National Institute of General Medical Sciences RL5GM118984, and the Tobacco-Related Disease Research Program under Award Numbers 24RT-0025 and 27IR-0030. M.P.-Y. was supported by the Ramón y Cajal Program (RYC-2015-17205) and by grant SAF2017-83417R from the Spanish Ministry of Economy, Industry and Competitiveness (MINECO/AEI/FEDER, UE). This work was also funded by grant AC15/00015 by Insituto de Salud Carlos III through Strategic Action for Health Research (AES) and European Community (EC) within the Active and Assisted Living (AAL) Programme framework and the SysPharmPedia grant from the ERACoSysMed 1stJoint Transnational Call from the European Union under the Horizon 2020 to M.P.-Y. L.-A.S-B. was supported by National Institute of General Medical Sciences of the National Institutes of Health under award number 5T32GM007546-42. The authors acknowledge the families and patients for their participation and thank the numerous health care providers and community clinics for their support and participation in GALA II/SAGE. In particular, the authors thank study coordinator Sandra Salazar; the recruiters who obtained the data: Duanny Alva, MD, Gaby Ayala-Rodriguez, Lisa Caine, Elizabeth Castellanos, Jaime Colon, Denise DeJesus, Blanca Lopez, Brenda Lopez, MD, Louis Martos, Vivian Medina, Juana Olivo, Mario Peralta, Esther Pomares, MD, Jihan Quraishi, Johanna Rodriguez, Shahdad Saeedi, Dean Soto, and Ana Taveras.
Publisher Copyright:
© 2019 The Authors Clinical Pharmacology & Therapeutics © 2019 American Society for Clinical Pharmacology and Therapeutics
PY - 2019/11/1
Y1 - 2019/11/1
N2 - American Thoracic Society guidelines recommend inhaled corticosteroid (ICS) therapy, plus a short-acting bronchodilator, in patients with persistent asthma. However, few prior studies have examined the efficacy of this combination in children of all racial/ethnic groups. We evaluated the association between ICS use and bronchodilator response (BDR) in three pediatric populations with persistent asthma (656 African American, 916 Puerto Rican, and 398 Mexican American children). The association was assessed using multivariable quantile regression. After adjusting for baseline forced expiratory volume in one second and use of controller medications, ICS use was significantly associated with increased BDR only among Mexican Americans (1.56%, P = 0.028) but not African Americans (0.49%, P = 0.426) or Puerto Ricans (0.16%, P = 0.813). Our results demonstrate that ICS augmentation is disproportionate across racial/ethnic groups, where improved BDR is observed in Mexican Americans only. This study highlights the complexities of treating asthma in children, and reinforces the importance of investigating the influence of race/ethnicity on pharmacological response.
AB - American Thoracic Society guidelines recommend inhaled corticosteroid (ICS) therapy, plus a short-acting bronchodilator, in patients with persistent asthma. However, few prior studies have examined the efficacy of this combination in children of all racial/ethnic groups. We evaluated the association between ICS use and bronchodilator response (BDR) in three pediatric populations with persistent asthma (656 African American, 916 Puerto Rican, and 398 Mexican American children). The association was assessed using multivariable quantile regression. After adjusting for baseline forced expiratory volume in one second and use of controller medications, ICS use was significantly associated with increased BDR only among Mexican Americans (1.56%, P = 0.028) but not African Americans (0.49%, P = 0.426) or Puerto Ricans (0.16%, P = 0.813). Our results demonstrate that ICS augmentation is disproportionate across racial/ethnic groups, where improved BDR is observed in Mexican Americans only. This study highlights the complexities of treating asthma in children, and reinforces the importance of investigating the influence of race/ethnicity on pharmacological response.
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U2 - 10.1002/cpt.1555
DO - 10.1002/cpt.1555
M3 - Article
C2 - 31209858
AN - SCOPUS:85069894523
SN - 0009-9236
VL - 106
SP - 1133
EP - 1140
JO - Clinical Pharmacology and Therapeutics
JF - Clinical Pharmacology and Therapeutics
IS - 5
ER -