Obese/overweight asthmatic children have decreased response to inhaled steroids
There is increasing evidence of an association between childhood asthma and obesity, but little is known about treatment responses in asthmatic children who are overweight or obese.
In a study published in the March 2011 issue of The Journal of Allergy and Clinical Immunology (JACI), Forno et al. looked at whether overweight or obesity affected response to treatment with an inhaled corticosteroid (budesonide) in 1,041 North American children who were followed over 4 to 6 years as part of the Childhood Asthma Management Program (CAMP) trial.
They found overweight/obese children showed no improvement in FEV1/FVC, a measure of lung function, over the 4 years of the trial. In contrast, children of normal weight had a significant improvement. Similar findings are reported for other lung function measures, need for prednisone, and emergency visits/hospitalizations for asthma. The reasons for this decreased response may include genetic differences, systemic inflammation associated with obesity, and/or hormone secretion by adipose tissue.
In summary, overweight/obese asthmatic children showed a significantly decreased response to inhaled corticosteroids, the first line of controller medications in the management of asthma. Treatment in these children may require simultaneous weight management and/or novel therapeutic approaches.
The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.