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. 2021 Feb;113(1):8-29.
doi: 10.1016/j.jnma.2020.07.001. Epub 2020 Jul 28.

Uncovering Outcome Disparities of β2 Adrenergic Agonists in Blacks: A Systematic Review

Rebecca N Jerome  1 , Jill M Pulley  2 , Nila A Sathe  3 , Shanthi Krishnaswami  4 , Alyssa B Dickerson  2 , Katherine J Worley  5 , Maria F Lima  6 , Consuelo H Wilkins  7
Affiliations

Uncovering Outcome Disparities of β2 Adrenergic Agonists in Blacks: A Systematic Review

Rebecca N Jerome et al. J Natl Med Assoc. 2021 Feb.

Abstract

Purpose: Outcome differences driven by variation in Blacks' biologic response to treatment may contribute to persistent racial disparities in asthma morbidity and mortality. This review assessed systematic variation in β2 agonist treatment outcomes among Blacks compared to other groups.

Methods: We conducted a systematic review of studies reporting differential response to β2 agonists among Blacks, including studies identifying pharmacogenetic variants.

Results: Of 3158 papers, 20 compared safety or efficacy of β2 agonists among Blacks as compared with other subgroups. Six papers evaluating efficacy of short-acting β2 agonists (SABA) found similar or improved results among Blacks compared with other groups, while one small study found reduced response to SABA therapy among Blacks. Reports of safety and efficacy of long-acting β2 agonists (LABA) indicated similar results among Blacks in four papers, while four reports found reduced safety among Blacks, as compared with other groups. Four papers assessed genomic variation and relative treatment response in Blacks, with two finding significant effects of the p.Arg16Gly variant in ADRB2 on β2 agonist response and one finding significant gene-gene IL6/IL6R interaction effects on albuterol response.

Conclusions: Evidence suggests the potential for differences in β2 agonist outcomes among Blacks compared with other groups. This literature, however, remains small and significantly underpowered for substantive conclusions. There are notable opportunities for adequately-powered investigations exploring safety and efficacy of β2 agonists among Blacks, including pharmacogenomic modifiers of response.

Keywords: Asthma; Beta-2 adrenergic agonists; Racial disparities; Safety; Treatment response.

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Conflict of interest statement

Declaration of Interest

The authors declare no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Figures

Figure 1.
Figure 1.. Disposition of studies identified for this review
*Numbers do not tally as studies could be excluded for multiple reasons. Abbreviations: n = Number. ** This review was part of a larger project including quasi-systematic reviews on two other drug classes, atypical antipsychotics and statins. Legend: This figure illustrates the review process, including the disposition of all articles during each step of the process as related to the systematic application of inclusion criteria.
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References

    1. CDC - Asthma - Most Recent Asthma Data. https://www.cdc.gov/asthma/most_recent_data.htm. Published July 14, 2017. Accessed January 8, 2018.
    1. Loftus PA, Wise SK. Epidemiology of asthma. Curr Opin Otolaryngol Head Neck Surg. 2016;24(3):245–249. doi:10.1097/MOO.0000000000000262 - DOI - PubMed
    1. Cazzola M, Rogliani P, Sanduzzi A, Matera MG. Influence of ethnicity on response to asthma drugs. Expert Opin Drug Metab Toxicol. 2015;11(7):1089–1097. doi:10.1517/17425255.2015.1047341 - DOI - PubMed
    1. Brown RW, Cappelletti CS. Reaching beyond disparity: safely improving asthma control in the at-risk African-American population. J Natl Med Assoc. 2013;105(2):138–149. - PubMed
    1. Mitchell SJ, Bilderback AL, Okelo SO. Racial Disparities in Asthma Morbidity Among Pediatric Patients Seeking Asthma Specialist Care. Acad Pediatr. 2016;16(1):64–67. doi:10.1016/j.acap.2015.06.010 - DOI - PubMed

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