In this MD Newsline exclusive interview with pulmonary and critical care physician Dr. Jamie Rutland, we discuss eosinophilic asthma, oral corticosteroids, and the Black community.
Is eosinophilic asthma more severe in the Black community?
Dr. Jamie Rutland:
“Here’s the thing. I would say that the presence of eosinophilic asthma leads to more severe asthma because eosinophils are white blood cells that are responsible for allergies, essentially. They have little granules on the inside, and when these granules are released from the eosinophil, they recruit more white blood cells to the area, and when that happens, you get a higher amount of inflammation.
But here’s the thing: Black people have lack of access to healthcare. In other words, they’re not going to know that they have eosinophilia. In other words, the eosinophilia is going to be present likely for a lot longer. They’re not going to get prednisone, which lowers your eosinophil count. They’re not going to get the necessary treatments, which are going to calm down the inflammation in the airway.
The inhaled corticosteroid as well. And so by that measure, it’s not exactly that, ‘oh, eosinophils in Black people are the worst eosinophils you can have.’ No. It’s that the eosinophilia has been present for a significant amount of time, which leads to a worse severity. It has nothing to do with being Black. Nothing.”
Can you speak a bit about corticosteroid-dependent asthma?
Dr. Jamie Rutland:
“So when you look at asthma that’s dependent on oral corticosteroids, there really is only one therapy for patients who have severe asthma that have the need of being on oral corticosteroids frequently. That is, a couple of times a month, every day, or how that physician defines it. And when you think about that, there’s only one type of biologic that’s indicated in that case. And that’s the biologic that I will offer my patients and give my patients.”