The objective of a new study published in The New England Journal of Medicine was to ascertain whether black patients with inadequately controlled asthma benefit more from the addition of a long-acting beta-agonist (LABA) than from increased glucocorticoids, as indicated by most clinical trials. In this study, two prospective, randomized, double-blind trials were conducted – one involving children and the other involving adolescents and adults. In both trials, the patients had at least one grandparent who identified as black and had asthma that was inadequately controlled with low-dose inhaled glucocorticoids. Here, combinations of therapy were compared—the addition of a LABA (salmeterol) to an inhaled glucocorticoid (fluticasone propionate); a step-up to double or quintuple the dose of fluticasone; or both. It was observed that when the quintupling dose of fluticasone (to 250 μg twice a day) was compared with adding salmeterol (50 μg twice a day) and doubling fluticasone (to 100 μg twice a day), a superior response occurred in 46% of children with quintupling the fluticasone and in 46% of the children with doubling the fluticasone and adding salmeterol. On the contrary, more adolescents and adults had a superior response to added salmeterol than to an increase in fluticasone. However, neither the degree of African ancestry nor baseline biomarkers predicted a superior response to specific treatments. While the increased dose of inhaled glucocorticoids was associated with a decrease in the ratio of urinary cortisol to creatinine in children younger than 8 years of age.The results demonstrated that in contrast to black adolescents and adults, almost half the black children with poorly controlled asthma had a superior response to an increase in dose of an inhaled glucocorticoid and almost half had a superior response to the addition of LABA.