- There are race-related differences in eosinophilic airway inflammation among asthmatic patients receiving inhaled corticosteroids (ICS).
Why this matters
- Increased risk of eosinophilic inflammation in ICS-treated (ICS+) African-Americans may reflect corticosteroid insensitivity.
- 17% of ICS+ participants had eosinophilic airway inflammation, with no significant differences between African-Americans and Caucasians.
- African-Americans with eosinophilic inflammation were twice as likely to have mixed granulocytic pattern (7% vs 3%; P=.02) and less likely to exhibit neutrophilic inflammation (71% vs 75%; P=.02).
- 36% of subjects not treated with ICS (ICS-) had eosinophilic inflammation, with no significant difference between African-Americans and Caucasians (39% vs 35%; P=.65).
- ICS- African-Americans with eosinophilic inflammation were 4 times as likely to have mixed granulocytic inflammation (14% vs 3%; P=.003).
- African-American subjects with noneosinophilic inflammation were twice as likely to exhibit neutrophilic inflammation (35% vs 17%; P=.004).
- On multivariable analysis, race was associated with eosinophilic inflammation in ICS+ subjects only (OR 1.58; 95% CI 1.01-2.48; P=.046).
- Secondary analysis of data from 10 clinical trials conducted by the Asthma Clinical Research Network and AsthmaNet.
- Funding: Asthma Clinical Research Network and AsthmaNet sponsored by National Heart, Lung, and Blood Institute.
- Clinical trial setting.
- Self-reported race.
- 2 inflammation phenotypes only.