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Black children with asthma less likely to respond to intramuscular steroid

Black children with asthma appeared less likely than white children to have a fractional exhaled nitric oxide response to intramuscular triamcinolone, according to study results.

Black children also experienced more exacerbations 4 weeks after administration of intramuscular triamcinolone.

Sergio Koo, MPH, of Royal Brompton & Harefield NHS Foundation Trust in London, and colleagues evaluated 79 children with severe therapy-resistant asthma for several factors, including assessment of steroid response.

Fifty-four (68%) of these children were white, whereas 16 (20%) were black, five (6%) were Asian and four (5%) were mixed race.

Researchers measured steroid response — defined according to symptoms, inflammation and spirometry — at baseline and 4 weeks after administration of intramuscular triamcinolone.

Results showed white children demonstrated a significant decline in median fractional exhaled nitric oxide (FeNO) after triamcinolone (46.8 ppb to 23.1 ppb, P < .001). The decline observed among black children did not reach statistical significance (52.2 ppb to 34.5 ppb).

Researchers classified a greater percentage of black children as FeNO nonresponders (86.7% vs. 45.3%; P < .05). Also, more black children experienced asthma exacerbations than white children (61% vs. 17%; P < .05).

“Further research is needed to understand the mechanisms of these differences, but they cannot be due to differences in adherence or access to care,” Koo and colleagues wrote. – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.