How does race and ethnicity effect the precision treatment of asthma?

Expert Rev Precis Med Drug Dev. 2019;4(6):337-356. doi: 10.1080/23808993.2019.1690396. Epub 2019 Nov 14.


Introduction: Asthma is a common condition that affects large numbers of children and adults, yet the burden of disease is not equally distributed amongst groups. In the United States, African Americans and Puerto Ricans have higher rates of asthma and its complications when compared with European Americans. However, clinical trials and genetic studies have largely focused on the latter group.

Areas covered: Here we examine what is known regarding differences in asthma treatment response by race-ethnicity. We also review existing genetic studies related to the use of asthma medications, paying special attention to studies that included substantial numbers of non-white population groups. Publicly accessible search engines of the medical literature were queried using combinations of the terms asthma, race, ethnicity, pharmacogenomics, and pharmacogenetics, as well as the names of individual asthma medication classes. The list of articles reviewed was supplemented by bibliographies and expert knowledge.

Expert opinion: A substantial and coordinated effort is still needed to both identify and validate genetic biomarkers of asthma medication response, as currently there are no clinically actionable genetic markers available for this purpose. The path to identifying such markers in non-white populations is even more formidable, since these groups are underrepresented in existing data.

Keywords: Asthma; Biologics; Ethnicity; Inhaled corticosteroids; Leukotriene antagonists; Long-acting beta-agonists; Pharmacogenetics; Pharmacogenomics; Race; Short-acting beta-agonists.