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.

中文翻译：

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儿科人群哮喘生物制剂资格的种族/民族差异

 背景

哮喘是一种异质性疾病。临床血液参数因种族/民族而异，用于区分哮喘亚型并为治疗提供信息。亚型的差异可以解释哮喘结果的人群特异性趋势。然而，种族/族裔少数儿童群体中的这些差异尚不清楚。

 客观的

我们研究了血液参数和哮喘亚型与哮喘结果的关联，并检查了少数儿科人群接受生物治疗的特定人群资格。

 方法

利用 2 项少数民族儿童哮喘病例对照研究的数据，我们进行了病例对照 (N = 3738) 和仅病例 (N = 2743) 逻辑回归，以量化血液参数和哮喘亚型与哮喘结果的关联。使用种族/民族与每次暴露之间的相互作用项来测试这些关联的异质性。使用卡方检验研究治疗资格的差异。

 结果

种族/族裔改变了总 IgE 与哮喘恶化之间的关联。波多黎各人 IgE 水平升高与哮喘预后较差相关。过敏性哮喘与墨西哥裔美国人的较差预后相关，而嗜酸性粒细胞性哮喘与波多黎各人的较差预后相关。与其他群体相比，波多黎各人符合过敏性哮喘定向生物治疗剂量标准的比例较低。与非裔美国人相比，波多黎各人中有更高比例的人有​​资格接受嗜酸粒细胞性哮喘定向生物治疗。

 结论

我们发现血液参数和哮喘亚型与哮喘结果之间存在特定人群的关联。我们的研究结果表明，哮喘生物治疗的资格在儿童种族/族裔群体中存在差异。这些发现呼吁对不同人群进行更多研究，以公平治疗少数哮喘患者。