Studies show path to tailored asthma prescribing

Research finds that race, certain biomarkers and genetic factors could indicate drug response and suggest strategies for getting asthma controlled on the first attempt.

By Victoria Stagg Elliott, AMNews staff. March 14, 2005.

Young asthmatic children who have not had the disease long could respond best to leukotriene receptor antagonists, but those with an allergic component and low pulmonary function might need inhaled corticosteroids. African-Americans may require higher doses to control their asthma. And the genetic expression profiles of nasal cells are different in those whose disease is stable versus those who are experiencing or at high risk of an asthma attack.

These are the conclusions of two studies published in the February Journal of Allergy and Clinical Immunology and another study in the journal Chest that experts say will lead to more effective prescribing from the get-go.

"We're hopefully getting closer to being able to identify why certain people respond to one type of treatment and some to another," said William E. Berger, MD, past president of the American College of Allergy, Asthma and Immunology.

Authors acknowledged, though, that none of these data is quite ready to play a role in determining initial prescribing, and the American Medical Association encourages physicians to make use of treatment guidelines from the National Heart, Lung and Blood Institute and the American Academy of Allergy, Asthma and Immunology.

"These things all have to be tested, validated and applied," said Stanley Szefler, MD, lead author on one of the JACI papers and head of pediatric clinical pharmacology at the National Jewish Medical and Research Center in Denver. "But it's an exciting era."