Reliever-Triggered Inhaled Glucocorticoid in Black and Latinx Adults with Asthma

Supported by a PCORI Award (PCS-1504-30283, to Dr. Israel), the Gloria M. and Anthony C. Simboli Distinguished Chair in Asthma Research award (to Dr. Israel), and by grants from the National Institute of Allergy and Infectious Diseases (K23AI125785, to Dr. Cardet) and the American Lung Association–American Academy of Allergy, Asthma, and Immunology (AI-835475, to Dr . Cardet). QVAR and QVAR RediHaler inhalers were provided free of charge and funding for the AssistRx pharmacy was provided by Suits you Pharmaceuticals. NIOX VERO devices for measuring exhaled nitric oxide were provided free of charge by Circassia Pharmaceuticals.

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

Drs. Israel and Cardet contributed equally to this article.

All the statements in this article, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors, or its Methodology Committee.

This article was published on February 26, 2022, and updated on March 31, 2022, at NEJM.org.

A data sharing statement provided by the authors is available with the full text of this article at NEJM.org.

We thank Julia Harder for medical writing assistance (paid through funds from the PCORI grant) with an earlier version of the manuscript; Craig P. Hersh for oversight of patient safety throughout the trial; the advisors listed here for assistance in the development of the trial design and implementation of the trial: Aracelis Diaz, Bridget Hickson, Margie Lorenzi, Kathy Monteiro, Wilfredo Morales-Cosme, Alexander Muniz Ruiz, Addie Perez, Richard Redondo, Marsha Santiago, Joyce Wade, and Mary White (patient partners); Rubin Cohen, Patricia W. Finn, Michael B. Foggs, Robert F. Lemanske, Jr., and Folashade Omole (professional society advisors); Mary Hart, Mario Herrera, and Sharon Schumack (patient advocacy advisors); Juan C. Celedón, Giselle Mosnaim, and Wanda Phipatanakul (expert scientific advisors); Sarah Alwardt, Arif M. Khan, and Troy Trygstad (health policy experts); Tiffany Bendelow, Lauren Bielick, Michelle Campbell Hayes, Erika M. Coleman, Jose Diarte Ortiz, Lynn Fukushima, Nicole P. Grant, Hernidia Guerra, Hilde Heyn, Renita Holmes, Bryonna Jackson, Mary Jo Day, Sylvia Johnson, Tiffani Kaage, Claudia Lechuga, Carese Lee, Brianna M. McQuade, Kathleen Mottus, Melissa Navarro, Grace Ndicu, Angela Nuñez, Pamela Pak, Luzmercy Perez, Matias E. Pollevick, Walter Ramos-Amador, Patricia Rebolledo, Jennifer Rees, Sarah B. Romain, Benjamin J. Rooks, Jasmin Sanchez, Catherine R. Smith, Lindsay E. Shade, Bonnie Telon Sosa, Jeremy Thomas, and Zinnia Valdes (trial site staff); the members of the American Academy of Family Physicians, Asthma Exacerbation Verification Group (Alicia Brooks-Greisen, Ileana Cepeda, Angie Lanigan, Cory B. Lutgen, Elizabeth Staton, and Carolyn Valdez); the members of the Asthma Research Center at Brigham and Women’s Hospital, Supplementary Asthma Exacerbation Verification Group (Eva Fandozzi, Katarina S. Gentile, Meghan N. Le, Allison O’Neill, and Abigail Fairbanks Tulchinsky); Shaddai Amolitos and Gabriela Gaona-Villarreal, of DARTNet Institute, for assistance with the data; Michael Pencina and Karen Chiswell, of Duke Clinical Research Institute, for assistance with the statistical analysis; Donna J. Walsh, of Brigham and Women’s Hospital, for assistance with the project finances; and all the trial participants and their families.

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