Racial/ethnic differences in eligibility for asthma biologics among pediatric populations.

Autor: Wohlford EM; Division of Pediatric Allergy and Immunology, University of California San Francisco, San Francisco, Calif; Department of Medicine, University of California San Francisco, San Francisco, Calif., Huang PF; Department of Medicine, University of California San Francisco, San Francisco, Calif., Elhawary JR; Department of Medicine, University of California San Francisco, San Francisco, Calif. Electronic address: jennifer.elhawary@ucsf.edu., Millette LA; Genentech Inc, South San Francisco, Calif., Contreras MG; Department of Medicine, University of California San Francisco, San Francisco, Calif., Witonsky J; Division of Pediatric Allergy and Immunology, University of California San Francisco, San Francisco, Calif; Department of Medicine, University of California San Francisco, San Francisco, Calif., Holweg CTJ; Genentech Inc, South San Francisco, Calif., Oh SS; Department of Medicine, University of California San Francisco, San Francisco, Calif., Lee C; Office of Minority Health and Health Equity, US Food and Drug Administration, Silver Spring, Md., Merenda C; Office of Minority Health and Health Equity, US Food and Drug Administration, Silver Spring, Md., Rabin RL; Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Md., Araojo R; Office of Minority Health and Health Equity, US Food and Drug Administration, Silver Spring, Md., Mak ACY; Department of Medicine, University of California San Francisco, San Francisco, Calif., Eng CS; Department of Medicine, University of California San Francisco, San Francisco, Calif., Hu D; Department of Medicine, University of California San Francisco, San Francisco, Calif., Huntsman S; Department of Medicine, University of California San Francisco, San Francisco, Calif., LeNoir MA; Bay Area Pediatrics, Oakland, Calif., Rodríguez-Santana JR; Centro de Neumologia Pediátrica, Caguas, Puerto Rico., Borrell LN; Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY., Burchard EG; Department of Medicine, University of California San Francisco, San Francisco, Calif; Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, Calif.
Jazyk: angličtina
Zdroj: The Journal of allergy and clinical immunology [J Allergy Clin Immunol] 2021 Nov; Vol. 148 (5), pp. 1324-1331.e12. Date of Electronic Publication: 2021 Sep 16.
DOI: 10.1016/j.jaci.2021.09.005
Abstrakt: Background: Asthma is a heterogeneous disease. Clinical blood parameters differ by race/ethnicity and are used to distinguish asthma subtypes and inform therapies. Differences in subtypes may explain population-specific trends in asthma outcomes. However, these differences in racial/ethnic minority pediatric populations are unclear.
Objective: We investigated the association of blood parameters and asthma subtypes with asthma outcomes and examined population-specific eligibility for biologic therapies in minority pediatric populations.
Methods: Using data from 2 asthma case-control studies of pediatric minority populations, we performed case-control (N = 3738) and case-only (N = 2743) logistic regressions to quantify the association of blood parameters and asthma subtypes with asthma outcomes. Heterogeneity of these associations was tested using an interaction term between race/ethnicity and each exposure. Differences in therapeutic eligibility were investigated using chi-square tests.
Results: Race/ethnicity modified the association between total IgE and asthma exacerbations. Elevated IgE level was associated with worse asthma outcomes in Puerto Ricans. Allergic asthma was associated with worse outcomes in Mexican Americans, whereas eosinophilic asthma was associated with worse outcomes in Puerto Ricans. A lower proportion of Puerto Ricans met dosing criteria for allergic asthma-directed biologic therapy than other groups. A higher proportion of Puerto Ricans qualified for eosinophilic asthma-directed biologic therapy than African Americans.
Conclusions: We found population-specific associations between blood parameters and asthma subtypes with asthma outcomes. Our findings suggest that eligibility for asthma biologic therapies differs across pediatric racial/ethnic populations. These findings call for more studies in diverse populations for equitable treatment of minority patients with asthma.
(Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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