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      Racial/ethnic-specific differences in the effects of inhaled corticosteroid use on bronchodilator response in patients with asthma

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          Abstract

          American Thoracic Society guidelines recommend inhaled corticosteroids (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 FEV 1 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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          Author and article information

          Journal
          0372741
          3058
          Clin Pharmacol Ther
          Clin. Pharmacol. Ther.
          Clinical pharmacology and therapeutics
          0009-9236
          1532-6535
          17 June 2019
          23 July 2019
          November 2019
          01 November 2020
          : 106
          : 5
          : 1133-1140
          Affiliations
          [1 ]Department of Medicine, University of California, San Francisco, CA, USA.
          [2 ]Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA.
          [3 ]Bay Area Pediatrics, Oakland, CA, USA.
          [4 ]Children’s Hospital and Research Center Oakland, Oakland, CA, USA.
          [5 ]Department of Pediatrics, Section of Pulmonology, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA.
          [6 ]Pediatric Pulmonary Division, Jacobi Medical Center, Bronx, NY, USA.
          [7 ]Department of Allergy and Immunology, Kaiser Permanente-Vallejo Medical Center, Vallejo, CA, USA.
          [8 ]Veterans Caribbean Health Care System, San Juan, Puerto Rico, USA.
          [9 ]The Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA.
          [10 ]Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA, USA.
          [11 ]Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, USA.
          [12 ]Centro de Neumologia Pediatrica, Caguas, Puerto Rico, USA.
          [13 ]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
          [14 ]CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
          Author notes

          AUTHOR CONTRIBUTIONS:

          All authors wrote the manuscript; L.S., S.S.O., T.J.N., and E.G.B. designed the research; S.S., C.E., K.M., E.B.B., M.A.L., H.J.F., D.S., W.R.C., K.B.D., L.N.B., J.R.R., and E.G.B. performed the research; L.S., S.S.O., T.J.N., J.L.E., M.W., T.E., A.M.Z., K.M., E.B.D., R.K., S.T., M.P.Y., L.N.B., and E.G.B. analyzed the data.

          Corresponding Author(s): Lesly-Anne Samedy, Department of Medicine, Lung Biology Center, Box 2911, UCSF, 1550 4 th St Rm 582, San Francisco, CA 94143, USA, Telephone: 415.514.9931, Fax: 415.514.4365, lessam21@ 123456gmail.com , Sam S. Oh, Department of Medicine, Lung Biology Center, Box 2911, UCSF, 1550 4 th St Rm 582, San Francisco, CA 94143, USA, Telephone: 415.514.9931, Fax: 415.514.4365, sam.oh@ 123456ucsf.edu
          Article
          PMC6778006 PMC6778006 6778006 nihpa1036444
          10.1002/cpt.1555
          6778006
          31209858
          a5ac544b-b373-4af8-b906-d6eb0e65a335
          History
          Categories
          Article

          Precision Medicine,African American,Ethnicity,Inhaled corticosteroids,Latino,Asthma

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