Study Shows Simple Intervention to Improve Asthma Outcomes for Black and Latinx Adults

Black and Latinx patients with moderate-to-severe asthma, who took inhaled glucocorticoids when they used reliever medications, in addition to usual care, had fewer severe asthma exacerbations, improved asthma control, improved quality of life and fewer days lost from work or school. These findings were reported from a new study just published in The New England Journal of Medicine. Michael Wechsler, MD, director of the National Jewish Health Cohen Family Asthma Institute, is one of the coinvestigators for this study.
 

A new approach to managing moderate-to-severe asthma that has gained interest and attention and has led to updated guidelines for patients, had not previously had studies that focus on populations that face a disproportionate burden of complications from asthma: African American/Black and Hispanic/Latinx populations. Individuals in these populations experience higher rates of asthma-related emergency department visits, higher rates of hospitalizations and approximately double the asthma mortality rate compared to white individuals.

“There have been efforts to improve this situation, but they have been mostly unsuccessful, and these populations tend to be underrepresented in clinical trials to gather more information,” said Dr. Wechsler. “Because of the greater burden of asthma in these patients, we need to identify better therapeutic options for them.”

The study was an open-label trial, conducted from November 2017 to April 2021, that included about 1,200 patients with moderate-to-severe asthma, split almost evenly between Black and Latinx persons, from the continental United States and Puerto Rico. The patients were randomly assigned to one of two groups. The experimental group received one-time instruction for using inhaled corticosteroids as needed, in addition to usual care. The control group just continued their usual care. There was only one study visit, and at that visit, participants received instructions, completed questionnaires, and watched a video appropriate to each group.

For the experimental group, this approach decreased the risk of severe asthma exacerbations by 15% (0.13 exacerbations per patient per year) compared to the control group. It also reduced asthma symptoms and days of impairment in Black and Latinx patients with moderate-to-severe asthma.

“I think any strategy that reduces exacerbations is an important one, and this level of reduction in this patient population is hugely beneficial,” said Dr. Wechsler. “This strategy is easy to implement and it might also be beneficial in other populations as well, so this is a good first step.”