Asthma Inhalers Fail Minority Children Due to a Lack of Diversity in Research

Kristen V. Brown, Gizmodo, March 17, 2018

When inhaled, the drug albuterol opens up the airways of the lungs, providing fast-acting relief to the wheezing and shortness of breath that often accompany an asthma attack. {snip} But it often fails minority children.

This failure is a form of discrimination embedded deep in the annals of medicine. One study found that 47 percent of African-American children and 67 percent of Puerto Rican children with moderate to severe asthma did not respond to albuterol. In 2014, African American people were almost three times more likely to die from asthma-related causes than their white counterparts. Part of the reason is that genetic differences affect how people respond to medical treatment. And the vast majority of participants in studies of both lung disease and genetics are of European descent.

Now a new study from UCSF published in the American Journal of Respiratory and Critical Care Medicine sheds some light on why.

“There is dramatic racial disparity in asthma prevalence, mortality, and albuterol drug response,” Angel Mak, a study author, told Gizmodo. “Puerto Ricans and African Americans have the highest asthma prevalence and mortality and lowest drug response compared to whites. Yet, over 95 percent of lung research [is] done on populations of European decent.”

{snip}

Several past studies, including others by UCSF, have demonstrated that genetic risk factors for asthma vary according to ancestral background. This study, though, was larger than previous ones and identified new genetic risk factors.

Environmental factors, like air quality, also put minorities at increased risk for asthma. But genetics are also a factor, and ethnic background is a key predictor of how well someone will respond to the drugs that treat it.

In 1993, Congress passed legislation requiring publicly funded medical studies to include more minorities. But in 2015, a review of lung disease studies found that only 5 percent of publicly funded research included patients of color. Similarly, a 2016 analysis found that 80 percent of participants in genome-wide association studies were European.

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