Biologic therapies for asthma in underserved populations

Abstract

Black and Hispanic children living in disadvantaged urban environments in the USA face a disproportionate burden of asthma, experiencing the highest rates of morbidity and mortality in the country. 1 Altman MC Calatroni A Ramratnam S et al. Endotype of allergic asthma with airway obstruction in urban children. J Allergy Clin Immunol. 2021; 148: 1198-1209 Summary Full Text Full Text PDF PubMed Scopus (11) Google Scholar The repeated exacerbations that accompany severe eosinophilic asthma in these populations can lead to loss of lung function, increased asthma severity, and progression to a pattern of fixed obstructive lung disease by early adulthood. 2 O'Brian AL Lemanske Jr, RF Evans MD Gangnon RE Gern JE Jackson DJ Recurrent severe exacerbations in early life and reduced lung function at school age. J Allergy Clin Immunol. 2012; 129: 1162-1164 Summary Full Text Full Text PDF PubMed Scopus (27) Google Scholar , 3 McGeachie MJ Yates KP Zhou X et al. Patterns of growth and decline in lung function in persistent childhood asthma. N Engl J Med. 2016; 374: 1842-1852 Crossref PubMed Scopus (350) Google Scholar Worryingly, in a substantial proportion of these children, conventional guideline-directed therapies, such as corticosteroids and long-acting β agonists, do not improve asthma control. Consequently, the identification of novel therapeutic strategies represents an important unmet need for underserved Black and Hispanic children living in urban areas. 4 Gonzalez Burchard E Borrell LN Need for racial and ethnic diversity in asthma precision medicine. N Engl J Med. 2021; 385: 2297-2298 Crossref PubMed Scopus (5) Google Scholar Mepolizumab for urban children with exacerbation-prone eosinophilic asthma in the USA (MUPPITS-2): a randomised, double-blind, placebo-controlled, parallel-group trialPhenotype-directed therapy with mepolizumab in urban children with exacerbation-prone eosinophilic asthma reduced the number of exacerbations. Full-Text PDF