Long acting beta-agonists along with inhaled corticosteroids did not reduce asthma exacerbations in black adults in a randomized trial.

The mean number of exacerbations was 0.42 exacerbations per person-year for LABA plus ICS, versus 0.37 exacerbations per person year for tiotropium plus ICS (rate ratio [RR] 0.90, 95% CI 0.73 to 1.11, log-rank P=0.31), Elliot Israel, MD, director of clinical research in the pulmonary and critical care division at Brigham and Women’s Hospital, in Boston, and colleagues wrote in the Oct. 27 issue of the Journal of the American Medical Association.

The probability of being free of exacerbation at 1 year was 74.0% for LABA plus ICS versus 75.7% for tiotropium plus ICS (hazard ratio [HR] 0.91, 95% CI 0.70 to 1.18, P=0.47), they said.

“Blacks represent a group that bears a disproportionate burden of asthma morbidity (2 times the rates of emergency room visits and hospitalizations and 2-3 times the death rate),” Israel wrote in an email to MedPage Today. “Differences persist even after correction for socioeconomic disparities.”

In addition, “Increasing evidence supports the therapeutic utility of anti-cholinergic agents for asthma, particularly for patients with airway obstruction or signs of higher cholinergic tone (e.g., lower resting heart rate),” David Lang, MD, chair of allergy and clinical immunology at the Cleveland Clinic, said in an email.

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