Effects of weight loss on asthma control in obese patients with severe asthma.

Eur Respir J. 2013 Nov 14. Dias-Júnior SA, Reis M, de Carvalho-Pinto RM, Stelmach R, Halpern A, Cukier A. Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.

Studies on the effects of weight loss in patients with asthma are scarce. No studies have been done in patients with severe asthma. To assess the impact of weight loss in patients with severe asthma associated with obesity.Open, prospective, randomized study of 2 parallel groups, in patients with severe uncontrolled asthma and moderate obesity. The primary outcome was the level of asthma control 6 months after initiation of the weight reduction program quantified by the Asthma Control Questionnaire (ACQ). We evaluated clinical parameters, and lung function, markers of airway inflammation and circulating cytokines.Twenty-two patients were randomized to undergo treatment for obesity, and 11 as the control group. The weight reduction program was associated with significant improvements in asthma control (ACQ mean±SE; 3.02±0.19 to 2.25±0.28 in the treatment group vs 2.91±0.25 to 2.90±0.16 in the controls, P=0.001). This improvement was not accompanied by changes in markers of airway inflammation or bronchial reactivity, but by an increase in forced vital capacity. Our results suggest that weight reduction in obese patients with severe asthma improves asthma outcomes by mechanisms not related to airway inflammation.

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