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SELECTED ARTICLES FROM THE RECENT LITERATURE 2007
August 16, 2007
Effects of patient obesity on therapeutic response to fluticasone
Summary
Background - It is generally accepted that prominent obesity is a risk factor for more severe asthma. Does this obesity effect involve the therapeutic response to inhaled corticosteroids (ICS) in asthma?
Findings - Boulet and Franssen of the Hopital Laval in Quebec, Canada found that in both obese and non-obese asthmatics, fluticasone (an ICS) combined with salmeterol (a LABA) was more effective than fluticasone alone in controlling asthma. However, for both treatments, the odds of achieving control were significantly lower in obese patients, particularly when the BMI was ? 40 kg/meter sq.
Reference
Respir Med 2007;Aug 6, E pub
Editor's Comments
The reasons for the decreased response to the asthma treatment in obese subjects in this study were not defined. Atopy (a risk factor for asthma) was more frequent in obese patients. It is unclear whether delivery of ICS and/or LABA to the lower airways is less effective in obese asthmatics.
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