Inhaled corticosteroids and augmented bronchodilator responsiveness in Latino and African American asthmatic patients.
BACKGROUND
National asthma guidelines recommend that patients with persistent asthma regularly use an inhaled corticosteroid (ICS) in addition to as-needed albuterol, yet recent debates question whether this combination is equally efficacious in all ethnicities.


OBJECTIVE
To examine the effect of ICS use on bronchodilator responsiveness to albuterol in 3 different ethnic populations.


METHODS
A cross-sectional study of 106 Mexican Americans, 246 Puerto Ricans, and 163 African Americans with physician-diagnosed persistent asthma. Asthma severity, ethnicity, and medication use were evaluated using spirometry and questionnaires. Percentage change in forced expiratory volume in 1 second (FEV) was compared in patients who used ICSs vs those who used a short-acting beta2-agonist as their only asthma medication.


RESULTS
Inhaled corticosteroid use was associated with improvements in the percentage change in FEV1 after albuterol administration in Mexican Americans (21.7%, P = .01) and Puerto Ricans (18.5%, P = .02) but not in African Americans (3.0%, P = .73).


CONCLUSIONS
Inhaled corticosteroid use is associated with augmented bronchodilator responsiveness to albuterol in Mexican Americans and Puerto Ricans, but not in African Americans, with persistent asthma. This underscores the need for an improved understanding of ethnic-specific drug-drug interactions, particularly in those subgroups experiencing the highest burden of asthma morbidity and mortality in the United States.
Naqvi
Mariam
M
University of California, San Francisco, California 94143-2911, USA.
Tcheurekdjian
Haig
H
DeBoard
Julie A
JA
Williams
L Keoki
LK
Navarro
Daniel
D
Castro
Richard A
RA
Rodriguez-Santana
Jose R
JR
Chapela
Rocio
R
Watson
H Geoffrey
HG
Meade
Kelley
K
Rodriguez-Cintron
William
W
LeNoir
Michael
M
Thyne
Shannon M
SM
Avila
Pedro C
PC
Choudhry
Shweta
S
Burchard
Esteban González
EG
D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000208:ethnology / Q000503:physiopathology; D001980:Bronchi / Q000187:drug effects / Q000473:pathology; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects / Q000502:physiology; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008297:Male; D012129:Respiratory Function Tests; D012737:Sex Factors; D014797:Vital Capacity / Q000502:physiology
D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents; D000420:Albuterol