For roughly 25 million Americans, living with asthma is a way of life. And for Black Americans, the realities of this chronic condition are even more profound. Despite ongoing advances in asthma therapies, the American Academy of Family Physicians (AAFP) says asthma exacerbation rates have dropped only marginally in the last 20 years. This week the medical organization representing more than 124,900 physicians and medical students nationwide, announced a partnership with Penn State College of Medicine that hopes to change that.
The collaboration has been approved for a $31 million funding award by the Patient-Centered Outcomes Research Institute (PCORI) to study the comparative effectiveness of asthma treatments. The project will focus on which of two treatment types— inhaled steroids or specific antibiotics, alone or together—works best in different patients. The research is expected to lead to a better understanding of the effectiveness of treatment, while also allowing researchers to determine if they can substantiate anecdotal reports of asthma "cures."
“Nearly all family physicians encounter patients with asthma, and we know that some patient groups face higher rates of death and high rates of severe complications,” said Julie Wood, MD, MPH, FAAFP, senior vice president of Research, Science and Health of the Public for the AAFP. “By further understanding which types of treatments are more or less effective for different patients, we can treat patients with asthma more effectively and help improve their quality of life.”
Medicine has never been a “one size fits all” solution, but historically, Blacks have been underrepresented in medical studies. The community’s relationship with medicine has been stymied by an unethical practice of using Black men and women for the advancement of science and to the detriment of Black bodies. Still, to reach parity in healthcare, the participation of Black Americans in clinical trials is not only important, it is necessary—particularly when that research focuses on a condition that disproportionately affects Blacks at far higher rates.
Wilson Pace, M.D., the clinical lead of the study for the American Academy of Family Physicians tells EBONY that not only do Blacks suffer from asthma more, but we are also more inclined to have exacerbations or attacks. “Many research studies do not include enough Blacks in their participants to be able to determine with certainty what the impact of an intervention or treatment will be for Black patients,” Pace says. ”For the iTREAT study, we will recruit enough Black patients for us to be able to definitively say what works for those patients. We will enroll 800 Black patients—25 percent of all participants—in order to collect the data we need to determine what treatments work to relieve them of their long-term asthma symptoms and lower their exacerbation rates.”
Asthma exacerbations are considered the leading cause of missed school or work for children and young adults, according to the Centers for Disease Control and Prevention (CDC). The Individualizing Treatment for Asthma in Primary Care (iTREAT-PC) study will test the interventions both alone and together in more than 3,000 people with asthma aged 12 and over. According to a release detailing the study, people will be followed for 16 months to determine which therapy is most effective in which individuals. The research will be conducted at 10 health care systems and research networks across the country that are part of the AAFP National Research Network (NRN).
“Reducing asthma disparities is a critical goal of this and our recently completed PREPARE research study,” says Pace. “ This project should provide the data primary care clinicians need to make individualized recommendations for asthma treatment to both Black and non-Black patients alike.”