BELT: Blacks & Exacerbations on LABA vs. Tiotropium

腰带:黑人

基本信息

  • 批准号:
    8245287
  • 负责人:
  • 金额:
    $ 213.77万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2010
  • 资助国家:
    美国
  • 起止时间:
    2010-09-30 至 2013-09-29
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Blacks bear a disproportionate burden of asthma morbidity and mortality. In its 2005 report on ethnic disparities in health care, AHRQ identified hospital admissions for asthma as the second largest disparity in quality of health care for Blacks versus Whites. Long-acting beta-agonists (LABAs), a popular treatment option for asthma, are in a class of drugs acting at ADRB2, which have been associated with rare loss of long-term asthma control and increased serious adverse outcomes including death and respiratory failure, even when used with ICS. The risk appears to be four to five-folds greater in Blacks than non-Black patients with asthma. Comparison of studies with LABA/ICS in Blacks versus studies where Blacks were a small minority suggests that Blacks may have much less benefit than other racial groups. Additionally, recent data (Wechsler 2009) suggest that a polymorphism at the 16th position of the ADRB2 gene identifies a group of Blacks (those homozygous for arginine (Arg16Arg)) in whom the response of adding a LABA to an ICS is further diminished. This polymorphism is present in ~20% of U.S. Blacks. In order to address the resulting knowledge gaps, a study is proposed to determine, in a one year practice-based, real-world, randomized, prospective, parallel group, longitudinal comparative effectiveness trial with the clinically important primary outcome of asthma exacerbations, whether in self-identified Black patients with asthma, treatment with LABA/ICS is superior to use of a non-2-adrenergic bronchodilator (tiotropium) combined with ICS (Tio/ICS). The study will also aim to determine, whether in the 20% of self-identified Black patients with asthma bearing Arg16Arg of ADRB2, treatment with LABA/ICS is superior to use of a non-2-adrenergic bronchodilator combined with ICS. PUBLIC HEALTH RELEVANCE: The results of this study will provide the information necessary to make evidence-based, individualized, recommendations concerning treatment algorithms and potential alternative treatment recommendations for the 3.5 million Blacks with asthma. The performance of this study in real life primary care settings will hasten the translation of these findings into day to day practice for this minority population that experiences a disproportionate burden of asthma and has been underrepresented in previous asthma studies.
描述(由申请人提供):黑人承担哮喘发病率和死亡率的不成比例负担。 AHRQ在2005年有关医疗保健种族差异的报告中,确定哮喘的住院是黑人与白人医疗保健质量的第二大差异。长效β-激动剂(LaBas)是一种哮喘的流行治疗选择,是在ADRB2作用的一类药物中,这与罕见的长期哮喘控制丧失以及严重的不良后果(包括死亡和呼吸衰竭)相关,即使与IC一起使用。黑人的风险似乎比非黑人哮喘患者大四到五倍。黑人与黑人的研究的研究比较黑人是少数族裔的研究表明,黑人的好处可能比其他种族群体要少得多。此外,最近的数据(Wechsler 2009)表明,ADRB2基因的第16位位置的多态性识别一组黑人(纯合的精氨酸(ARG16ARG)),其中将LABA添加到ICS中的反应进一步减少。这种多态性存在于约20%的美国黑人中。为了解决由此产生的知识差距,提出了一项研究,以确定一年的实践,现实,随机,前瞻性,并行组,纵向比较有效性试验,以及哮喘患者的临床重要主要结果,是否是否在自我识别的黑人哮喘患者中,LABA/ICS治疗优于使用非2-肾上腺素能支气管扩张剂(Tiotopium)与ICS(TIO/ICS)结合使用。这项研究还将旨在确定在20%的自识别的黑人患有ADRB2的哮喘轴承的黑人患者中,使用LABA/ICS治疗是否优于使用非2-肾上腺素能支气管扩张剂与ICS结合使用。 公共卫生相关性:这项研究的结果将提供必要的信息,以提出有关治疗算法的基于证据的,个性化的建议以及对350万黑人哮喘的潜在替代治疗建议。这项研究在现实生活中的初级保健环境的表现将加快这些发现的转化为这一少数群体的日常练习,这种少数人遭受哮喘的负担不足,并且在先前的哮喘研究中的代表性不足。

项目成果

期刊论文数量(1)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

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Elliot Israel其他文献

Elliot Israel的其他文献

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{{ truncateString('Elliot Israel', 18)}}的其他基金

Project 3: Therapeutic Control of AERD
项目3:AERD的治疗控制
  • 批准号:
    10208132
  • 财政年份:
    2020
  • 资助金额:
    $ 213.77万
  • 项目类别:
PATINA - Precision Administration of Treatment in Neutrophilic severe Asthma
PATINA - 中性粒细胞性严重哮喘的精准治疗
  • 批准号:
    9406614
  • 财政年份:
    2017
  • 资助金额:
    $ 213.77万
  • 项目类别:
PATINA - Precision Administration of Treatment in Neutrophilic severe Asthma
PATINA - 中性粒细胞性严重哮喘的精准治疗
  • 批准号:
    10454802
  • 财政年份:
    2017
  • 资助金额:
    $ 213.77万
  • 项目类别:
PATINA - Precision Administration of Treatment in Neutrophilic severe Asthma
PATINA - 中性粒细胞性严重哮喘的精准治疗
  • 批准号:
    9751385
  • 财政年份:
    2017
  • 资助金额:
    $ 213.77万
  • 项目类别:
PATINA - Precision Administration of Treatment in Neutrophilic severe Asthma
PATINA - 中性粒细胞性严重哮喘的精准治疗
  • 批准号:
    10216322
  • 财政年份:
    2017
  • 资助金额:
    $ 213.77万
  • 项目类别:
PATINA - Precision Administration of Treatment in Neutrophilic severe Asthma
PATINA - 中性粒细胞性严重哮喘的精准治疗
  • 批准号:
    9979941
  • 财政年份:
    2017
  • 资助金额:
    $ 213.77万
  • 项目类别:
PESBART: Effects of Physical Environment and Stress in Blacks in Relation to Asth
PESBART:物理环境和压力对黑人哮喘的影响
  • 批准号:
    8692300
  • 财政年份:
    2013
  • 资助金额:
    $ 213.77万
  • 项目类别:
AMSA: ALXR/FBR Mediated Signaling in Severe Asthma
AMSA:ALXR/FBR 介导的严重哮喘信号传导
  • 批准号:
    8496109
  • 财政年份:
    2011
  • 资助金额:
    $ 213.77万
  • 项目类别:
Lipoxins in Severe Asthma (LIPSA)
严重哮喘中的脂氧素 (LIPSA)
  • 批准号:
    8263755
  • 财政年份:
    2011
  • 资助金额:
    $ 213.77万
  • 项目类别:
AMSA: ALXR/FBR Mediated Signaling in Severe Asthma
AMSA:ALXR/FBR 介导的严重哮喘信号传导
  • 批准号:
    8316388
  • 财政年份:
    2011
  • 资助金额:
    $ 213.77万
  • 项目类别:

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非西班牙裔黑人 HCC 的基因组和环境驱动因素:先天和后天
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