Racial/Ethnic-Specific Differences in the Effects of Inhaled Corticosteroid Use on Bronchodilator Response in Patients With Asthma.

Autor: Samedy-Bates LA; Department of Medicine, University of California, San Francisco, California, USA.; Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, California, USA., Oh SS; Department of Medicine, University of California, San Francisco, California, USA., Nuckton TJ; Department of Medicine, University of California, San Francisco, California, USA., Elhawary JR; Department of Medicine, University of California, San Francisco, California, USA., White M; Department of Medicine, University of California, San Francisco, California, USA., Elliot T; Department of Medicine, University of California, San Francisco, California, USA., Zeiger AM; Department of Medicine, University of California, San Francisco, California, USA., Eng C; Department of Medicine, University of California, San Francisco, California, USA., Salazar S; Department of Medicine, University of California, San Francisco, California, USA., LeNoir MA; Bay Area Pediatrics, Oakland, California, USA., Meade K; Children's Hospital and Research Center Oakland, Oakland, California, USA., Farber HJ; Department of Pediatrics, Section of Pulmonology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA., Serebrisky D; Pediatric Pulmonary Division, Jacobi Medical Center, Bronx, New York, USA., Brigino-Buenaventura E; Department of Allergy and Immunology, Kaiser Permanente-Vallejo Medical Center, Vallejo, California, USA., Rodriguez-Cintron W; Veterans Caribbean Health Care System, San Juan, Puerto Rico, USA., Bibbins-Domingo K; Department of Medicine, University of California, San Francisco, California, USA., Kumar R; The Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA., Thyne S; Department of Pediatrics, University of California Los Angeles, Los Angeles, California, USA., Borrell LN; Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, New York, USA., Rodriguez-Santana JR; Centro de Neumologia Pediatrica, Caguas, Puerto Rico, USA., Pino-Yanes M; Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain.; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain., Burchard EG; Department of Medicine, University of California, San Francisco, California, USA.; Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, California, USA.
Jazyk: angličtina
Zdroj: Clinical pharmacology and therapeutics [Clin Pharmacol Ther] 2019 Nov; Vol. 106 (5), pp. 1133-1140. Date of Electronic Publication: 2019 Jul 23.
DOI: 10.1002/cpt.1555
Abstrakt: 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.
(© 2019 The Authors Clinical Pharmacology & Therapeutics © 2019 American Society for Clinical Pharmacology and Therapeutics.)
Databáze: MEDLINE
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