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Racial and Socioeconomic Differences in Real-World Use of Biologic Therapy for Asthma
Monica Littlejohn1, Autumn D Zuckerman1, Nicolas Gargurevich2
1Vanderbilt Specialty Pharmacy, Vanderbilt University Medical Center, Nashville, TN, USA.
Journal of Asthma and Allergy
|June 11, 2026
Summary
Black or African American patients with asthma showed lower lung function at biologic initiation. While not statistically significant, this trend suggests earlier interventions may be beneficial for this group.
Area of Science:
- Pulmonology
- Health Disparities
- Pharmacotherapy
Background:
- Biologic therapies are crucial for managing moderate-to-severe asthma.
- Understanding disparities in treatment initiation and response is essential for equitable care.
- Race and socioeconomic factors may influence asthma management and outcomes.
Purpose of the Study:
- To investigate racial and socioeconomic differences in baseline asthma severity at biologic initiation.
- To determine if these factors are associated with treatment response within 18 months.
- To evaluate racial disparities in clinic engagement, healthcare utilization, and biologic adherence.
Main Methods:
- Retrospective review of 215 patients with moderate-to-severe asthma initiating biologic therapy (2019-2022).
- Multiple linear regression analyzed associations between race, socioeconomic status, and lung function (ppFEV1).
- Wilcoxon rank sum tests assessed racial differences in clinic engagement and healthcare utilization; adherence via Proportion of Days Covered (PDC).
Main Results:
- Black or African American/Other patients had a trend towards lower baseline ppFEV1 (6.9% lower, p=0.057) and higher appointment no-show rates (p<0.001).
- No significant racial differences in healthcare utilization or ppFEV1 response at 18 months post-initiation were observed.
- Biologic adherence (median PDC 0.96) and socioeconomic status were similar across racial groups.
Conclusions:
- A trend of lower baseline lung function in Black or African American/Other patients suggests a potential need for earlier interventions.
- While not statistically significant, these findings highlight an opportunity to address disparities in asthma care.
- Further research is warranted to explore early intervention strategies for underrepresented racial groups.
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