Step-Up Therapy in Black Patients with Asthma

To the Editor: Wechsler et al. (Sept. 26 issue)¹ describe differences in clinical responses between black children and white children to step-up treatment with an inhaled glucocorticoid versus a long-acting beta-agonist (LABA) for asthma. The study highlights gaps in scientific knowledge, which is used to develop and support treatment guidelines, as a result of a lack of inclusion of diverse populations in research studies (see Table S1 in the Supplementary Appendix, available with the full text of this letter at NEJM.org). Monoclonal antibody therapies represent an emerging treatment for moderate and severe asthma in children. We searched ClinicalTrials.gov and other . . .