title: Inhaled corticosteroids and augmented bronchodilator responsiveness in Latino and African American asthmatic patients.
abstract: 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.
authors.affiliation: University of California, San Francisco, California 94143-2911, USA.
authors.forename: Mariam
authors.initials: M
authors.lastname: Naqvi
authors.forename: Haig
authors.initials: H
authors.lastname: Tcheurekdjian
authors.forename: Julie A
authors.initials: JA
authors.lastname: DeBoard
authors.forename: L Keoki
authors.initials: LK
authors.lastname: Williams
authors.forename: Daniel
authors.initials: D
authors.lastname: Navarro
authors.forename: Richard A
authors.initials: RA
authors.lastname: Castro
authors.forename: Jose R
authors.initials: JR
authors.lastname: Rodriguez-Santana
authors.forename: Rocio
authors.initials: R
authors.lastname: Chapela
authors.forename: H Geoffrey
authors.initials: HG
authors.lastname: Watson
authors.forename: Kelley
authors.initials: K
authors.lastname: Meade
authors.forename: William
authors.initials: W
authors.lastname: Rodriguez-Cintron
authors.forename: Michael
authors.initials: M
authors.lastname: LeNoir
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Thyne
authors.forename: Pedro C
authors.initials: PC
authors.lastname: Avila
authors.forename: Shweta
authors.initials: S
authors.lastname: Choudhry
authors.forename: Esteban González
authors.initials: EG
authors.lastname: Burchard
mesh_terms: 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
chemical_list: D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents; D000420:Albuterol