In a new study, blacks who were asthmatic and nonasthmatic required higher doses of glucocorticoids, or controller medications, to reduce airway inflammation. Because of this, blacks may be more likely to have a reduced medication response, and therefore,their asthma symptoms may be more difficult to control.

The study also shows age was the only other significant variable that affected glucocorticoid response. Even in healthy populations without disease or inflammation, response to steroids changed over time.

Researchers from the National Jewish Medical and Research Center and the University of Colorado Health Sciences Center evaluated whether blacks have a racial disposition to a diminished response to a glucocorticoid. Researchers preformed blood tests on 395 patients with asthma and 202 patients without asthma.

When both black and white patients with asthma who had a similar degree of airflow limitation and comparable controller medication requirements were tested, African-American patients required grater concentration of the glucocorticoid medication to suppress airway inflammation. This difference in response between blacks and whites was also present in patients without asthma.

"Regardless of asthma status or severity, African-Americans in our study required higher doses of a glucocorticoid than Caucasians to inhibit proliferation of these inflammatory cells", says Ronina Covar, M.D. "This observation suggests that African-Americans may have an inherent predisposition that affects their ability to respond to certain medications at recommended doses."

"These patients whose asthma is not adequately controlled on usual medication doses may benefit from a higher dose or the addition of other controller medications." A higher dose isn't necessarily needed for other ailments, such as rheumatologic and gastrointestinal problems, that are also treated with the glucocorticoid medication.

SOURCE: Neurology, 2005;571-578