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| |  Black Teen-Age Asthmatics More Likely Than Whites To Be Steroid Resistant DENVER, CO -- July 23, 1998 -- Black teen-agers are three times more likely than white teen-agers to have steroid resistant asthma, research at National Jewish Medical and Research Center has found. "Our results suggest that children with steroid-resistant asthma are more likely to be African-American, to have required treatment with oral steroids at an earlier age and to require larger amounts of oral steroids for only marginal control of their asthma," said Joseph Spahn, M.D., a pediatric allergist and director of the Immunopharmacology Lab at National Jewish. Other recent epidemiological studies have shown that blacks with asthma are sicker and have a higher mortality rate than whites with asthma. Doctors at National Jewish now are trying to determine whether blacks have a more vigorous immune response to airway inflammation -- which means that higher doses of steroids must be used to control inflammation -- or a poor response to steroids secondary to a genetic resistance to the drugs. "The theory is that with ongoing airway inflammation you get worsening asthma and diminished steroid sensitivity," Dr. Spahn said. This study of 164 teen-agers treated at National Jewish also showed that 25 percent of the group was steroid resistant. Children with less than a 15 percent improvement in lung function following a burst of inhaled steroids -- high doses over seven days -- were considered steroid resistant. "Twenty-five percent of the kids admitted to National Jewish have steroid-resistant asthma, which is much greater than anyone thought," Dr. Spahn said. It has been estimated that only one-tenth of a percent of the 15 million people in the United States with asthma are steroid resistant. About five million children in the U.S. have asthma. The study, published in the Journal of Allergy and Clinical Immunology, is the first to examine steroid-resistant asthma in children. A person with steroid-resistant asthma receives limited reduction in airway inflammation and swelling following treatment with oral steroids. Inhaled steroids are one of the main ways that asthma is controlled. "Asthma can be a progressive disease," Dr. Spahn said. "It's really important to take medication even when you're feeling well."
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