@article{457ec499c4084ab2872bcf9d011520fc,
title = "Exacerbation-prone asthma in the context of race and ancestry in Asthma Clinical Research Network trials",
abstract = "Background: Minority groups of African descent experience disproportionately greater asthma morbidity compared with other racial groups, suggesting that genetic variation from a common ancestry could influence exacerbation risk. Objective: We evaluated clinical trial measures in the context of self-reported race and genetic ancestry to identify risk factors for asthma exacerbations. Methods: One thousand eight hundred forty multiethnic subjects from 12 Asthma Clinical Research Network and AsthmaNet trials were analyzed for incident asthma exacerbations with Poisson regression models that included clinical measures, self-reported race (black, non-Hispanic white, and other), and estimates of global genetic African ancestry in a subgroup (n = 760). Results: Twenty-four percent of 1840 subjects self-identified as black. Black and white subjects had common risk factors for exacerbations, including a history of 2 or more exacerbations in the previous year and FEV1 percent predicted values, whereas chronic sinusitis, allergic rhinitis, and gastroesophageal reflux disease were only associated with increased exacerbation risk in black subjects. In the combined multiethnic cohort, neither race (P = .30) nor percentage of genetic African ancestry as a continuous variable associated with exacerbation risk (adjusted rate ratio [RR], 1.26 [95% CI, 0.94-1.70; P = .13]; RR per 1-SD change [32% ancestry], 0.97 [95% CI, 0.78-1.19; P = .74]). However, in 161 black subjects with genetic data, those with African ancestry greater than the median (≥82%) had a significantly greater risk of exacerbation (RR, 3.06 [95% CI, 1.09-8.6; P = .03]). Conclusion: Black subjects have unique risk factors for asthma exacerbations, of which global African genetic ancestry had the strongest effect.",
keywords = "African American, Exacerbations, admixture, ancestry, asthma, black, ethnic group, genetics, lung function, race",
author = "Grossman, {Nicole L.} and Ortega, {Victor E.} and King, {Tonya S.} and Bleecker, {Eugene R.} and Ampleford, {Elizabeth A.} and Bacharier, {Leonard B.} and Cabana, {Michael D.} and Cardet, {Juan C.} and Carr, {Tara F.} and Mario Castro and Denlinger, {Loren C.} and Denson, {Joshua L.} and Nicolas Fandino and Fitzpatrick, {Anne M.} and Hawkins, {Gregory A.} and Fernando Holguin and Krishnan, {Jerry A.} and Lazarus, {Stephen C.} and Nyenhuis, {Sharmilee M.} and Wanda Phipatanakul and Ramratnam, {Sima K.} and Sally Wenzel and Peters, {Stephen P.} and Meyers, {Deborah A.} and Wechsler, {Michael E.} and Elliot Israel",
note = "Funding Information: Supported by grants from the National Institutes of Health / National Heart, Lung, and Blood Institute ( K08 HL118128 and R01 HL142992 ) and AsthmaNet (grants HL098102 , HL098096 , HL098075 , HL098090 , HL098177 , HL098098 , HL098107 , HL098112 , HL098103 , and HL098115 ). Funding Information: Supported by grants from the National Institutes of Health/National Heart, Lung, and Blood Institute (K08 HL118128 and R01 HL142992) and AsthmaNet (grants HL098102, HL098096, HL098075, HL098090, HL098177, HL098098, HL098107, HL098112, HL098103, and HL098115).Disclosure of potential conflict of interest: T. S. King reports personal fees from Pearl Therapeutics and Insmed, all outside the submitted work. E. R. Bleecker reports clinical trial funding through his institutions from AstraZeneca, MedImmune, Boehringer Ingelheim, Genentech, Johnson and Johnson (Janssen), Novartis, Regeneron, and Sanofi Genzyme and reports consultancy fees from AstraZeneca, MedImmune, Boehringer Ingelheim, GlaxoSmithKline, Novartis, Regeneron, and Sanofi Genzyme, all are outside the submitted work. L. B. Bacharier reports consultancy fees from Aerocrine, GlaxoSmithKline, Genentech/Novartis, TEVA, AstraZeneca, Boehringer Ingelheim, and Vectura; reports personal fees for advisory board participation from Merck, Sanofi/Regeneron, Vectura, and Circassia, as well as fees for Data Safety and Monitoring Board participation from DBV Technologies; is a speaker for Genentech/Novartis, TEVA, AstraZeneca, Sanofi/Regeneron, and Boehringer Ingelheim; and reports honoraria from WebMD/Medscape, all outside the submitted work. M. D. Cabana reports consultancy fees from Genentech and Novartis, outside the submitted work. T. F. Carr reports consultancy fees from AstraZeneca, Sanofi-Regeneron, and Boehringer Ingelheim, as well as royalties from Wolters-Kluwer (UpToDate), all outside the submitted work. M. Castro reports pharmaceutical grant funding to his institution from AstraZeneca, Boeringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, and sanofi Aventis; reports consultancy fees from Aviragen, Boston Scientific, Genentech, Nuvaira, Neutronic, Therabron, Theravance, Vectura, 4D Pharma, VIDA, Mallinckrodt, TEVA, and Sanofi Aventis; is a speaker for AstraZeneca, Boeringer Ingelheim, Boston Scientific, Genentech, Regeneron, Sanofi, TEVA; and reports royalties from Elsevier, all outside the submitted work. L. C. Denlinger reports personal fees from AstraZeneca, Sanofi Regeron, and GlaxoSmithKline, all outside the submitted work. J. A. Krishnan reports personal fees for Independent Data Monitoring Committee participation from Sanofi, all outside the submitted work. S. C. Lazarus reports grant funding from the American Lung Association–Airway Clinical Research Centers Network, all outside the submitted work. W. Phipatanakul reports consultancy fees from Genentech, Novartis, Regeneron, GlaxoSmithKline, and AstraZeneca and reports grant funding to her institution from Genentech, Thermo Fisher, and ALK-Abell{\'o}, all outside the submitted work. S. Wenzel reports having been the principal investigator on studies sponsored by AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, and Sanofi; reports consultancy fees for AstraZeneca, Sanofi, and Pieris; and has received royalties from UpToDate, all outside the submitted work. M. E. Wechsler reports grant funding to his institution from AstraZeneca, Novartis, Sanofi, GlaxoSmithKline, Boston Scientific, and TEVA and reports consultancy fees from AstraZeneca, Novartis, Sanofi, GlaxoSmithKline, Boston Scientific, TEVA, Regeneron, Mylan, Genentech, Restorbio, Equilium, and Boehringer Ingelheim, all outside the submitted work. E. Israel reports consultancy fees from AstraZeneca, Novartis, Regeneron Pharmaceuticals, TEVA Specialty Pharmaceuticals, Bird Rock Bio, Nuvelution Pharmaceuticals, Vitaeris, Sanofi Genzyme, Merck, Entrinsic Health Solutions, GlaxoSmithKline, Vorso, Pneuma Respiratory, 4D Pharma, Sienna Biopharmaceutical, Equillium, and Genentech and reports grant funding through his institution from Genentech, Novartis, Sanofi, Boehringer Ingelheim, AstraZeneca, TEVA Specialty Pharmaceuticals, and Circassia, all outside the submitted work. The rest of the authors declare that they have no relevant conflicts of interest. Publisher Copyright: {\textcopyright} 2019 American Academy of Allergy, Asthma & Immunology",
year = "2019",
month = dec,
doi = "10.1016/j.jaci.2019.08.033",
language = "English (US)",
volume = "144",
pages = "1524--1533",
journal = "Journal of Allergy and Clinical Immunology",
issn = "0091-6749",
publisher = "Mosby Inc.",
number = "6",
}