The Journal of Allergy and Clinical Immunology: In Practice
Original ArticleRacial Disparities in Asthma-Related Health Outcomes in Children with Severe/Difficult-to-Treat Asthma
Section snippets
TENOR study design
TENOR was a 3-year (2001-2004), multicenter, prospective, observational study conducted at 283 sites in the United States. The details of the study design and methodology, as well as baseline cohort characteristics, have been previously published.14, 15 Briefly, TENOR enrollment included patients 6 years of age and older from diverse geographic areas with severe or difficult-to-treat asthma receiving care from an allergist or pulmonologist. Patients were selected for TENOR if they: (1) had
Univariable analyses
A total of 86 black children and 262 white children aged 6-11 years were included in the analyses. Mean age at baseline was similar between black and white children: 9.2 ± 1.6 vs 9.0 ± 1.7, respectively (Table I). Black children were more likely than white children to be male (79.1% vs 66.4%; P = .03), to reside in urban core areas (80.2% vs 61.8%; P = .006 for overall comparison of residential area), to be in a lower family income stratum (USD43,400 vs 55,770; P < .001), and to have Medicaid
Discussion
This report from the TENOR observational study provides the most comprehensive assessment of the black/white differences in pediatric asthma by attempting to explain the poorer asthma-related health outcomes in black patients using a rigorous statistical approach of sequential adjustment for confounding variables. In addition, this study examined a wide breadth of variables, including demographic, clinical, and patient-reported outcomes in a real-world setting, some of which have not been
Acknowledgments
The authors would like to thank the investigators, patients, and parents/caregivers who participated in TENOR.
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The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens study and this analysis were funded by Genentech, Inc., South San Francisco, CA, and Novartis Pharmaceuticals Corporation, East Hanover, NJ.
Conflicts of interest: T. Guilbert receives personal fees from American Board of Pediatrics Pediatric Pulmonary Subboard, GSK, Regeneron Pharmaceuticals, Merck, Sanofi/Regeneron, Novartis/Regeneron, GSK/Regneron, and Aviragen; grants from the National Institutes of Health (NIH) and Sanofi/Regeneron; and royalties from UpToDate. R. S. Zeiger is employed by the Southern California Permanente Medical Group. He reports grants from the National Heart, Lung, and Blood Institute (NHLBI), Aerocrine, Genentech, AstraZeneca/MedImmune, and Merck; and personal fees from AstraZeneca, Genentech, Novartis, TEVA, GlaxoSmithKline, Theravance BioPharma, Regeneron Pharmaceuticals, Sanofi, and Patara Pharma. T. Haselkorn has received consulting fees from Genentech, Inc. and Novartis Pharmaceuticals Corp. A. Iqbal is an employee of Genentech, Inc. C. Alvarez and D. R. Mink have received funding from Genentech, Inc. through their employer, ICON Clinical Research, for statistical support of the Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens study. B. E. Chipps has received consulting/advisory board and speaker bureau fees from AstraZeneca, Boehringer Ingelheim, Circassia, Genentech, Inc., Novartis, and Teva. S. J. Szefler has consulted for Aerocrine, AstraZeneca, Boehringer Ingelheim, Daiichi Sankyo, GlaxoSmithKline, Genentech, Merck, Novartis, Propeller Health, Roche, and Teva; and has received research support from the NIH, the NHLBI, the Colorado Department of Public Health and Environment Colorado Cancer, Cardiovascular and Pulmonary Disease Program, and GlaxoSmithKline.