OBJECTIVE: To explore whether obesity alters the risk, impairment and response to treatment in African Americans with asthma. METHODS: The data used for this secondary analysis are from a 1-year study in African American subjects comparing fluticasone propionate/salmeterol 100/50 microg combination (FSC) and fluticasone propionate 100 microg (FP). Subjects were retrospectively stratified by body mass index (BMI) <20 [underweight], 20-24.9 [normal weight], 25-29.9 [overweight], 30-34.9 [obese I], 35-39.9 [obese II], and >or=40 [obese III] kg/m(2). Outcomes studied included impairment domains: FEV(1), morning and evening peak expiratory flow (AM and PM PEF), daily albuterol use, daily symptom scores and future risk domain: exacerbations. CLINICAL TRIAL REGISTRATION: www.clinicaltrials.gov; NCT00102765. RESULTS: There were 475 subjects evenly distributed between FSC and FP by baseline parameters. There were 207 subjects with a BMI >or=30, including 70 subjects with a BMI >or=40. Baseline BMI >or=40 was associated with numerically lower baseline AM and PM PEF. There was an attenuation of response to both treatments for only PM PEF (p < 0.05). By contrast, subjects with lower degrees of obesity or overweight did not differ from those with normal weight. The total population exacerbation rate was 2-fold greater in obese III subjects (39%) compared with subjects in other BMI categories (16-21%) (p < 0.05). A potential study limitation is the retrospective analysis of existing data. DISCUSSION: Response to treatment was attenuated for PM PEF for subjects with BMI >or=40 and was also associated with an increased rate of asthma exacerbations.
OBJECTIVE: To explore whether obesity alters the risk, impairment and response to treatment in African Americans with asthma. METHODS: The data used for this secondary analysis are from a 1-year study in African American subjects comparing fluticasone propionate/salmeterol 100/50 microg combination (FSC) and fluticasone propionate 100 microg (FP). Subjects were retrospectively stratified by body mass index (BMI) <20 [underweight], 20-24.9 [normal weight], 25-29.9 [overweight], 30-34.9 [obese I], 35-39.9 [obese II], and >or=40 [obese III] kg/m(2). Outcomes studied included impairment domains: FEV(1), morning and evening peak expiratory flow (AM and PM PEF), daily albuterol use, daily symptom scores and future risk domain: exacerbations. CLINICAL TRIAL REGISTRATION: www.clinicaltrials.gov; NCT00102765. RESULTS: There were 475 subjects evenly distributed between FSC and FP by baseline parameters. There were 207 subjects with a BMI >or=30, including 70 subjects with a BMI >or=40. Baseline BMI >or=40 was associated with numerically lower baseline AM and PM PEF. There was an attenuation of response to both treatments for only PM PEF (p < 0.05). By contrast, subjects with lower degrees of obesity or overweight did not differ from those with normal weight. The total population exacerbation rate was 2-fold greater in obese III subjects (39%) compared with subjects in other BMI categories (16-21%) (p < 0.05). A potential study limitation is the retrospective analysis of existing data. DISCUSSION: Response to treatment was attenuated for PM PEF for subjects with BMI >or=40 and was also associated with an increased rate of asthma exacerbations.
Authors: Jason E Lang; Anne M Fitzpatrick; David T Mauger; Theresa W Guilbert; Daniel J Jackson; Robert F Lemanske; Fernando D Martinez; Robert C Strunk; Robert S Zeiger; Wanda Phipatanakul; Leonard B Bacharier; Jacqueline A Pongracic; Fernando Holguin; Michael D Cabana; Ronina A Covar; Hengameh H Raissy; Monica Tang; Stanley J Szefler Journal: J Allergy Clin Immunol Date: 2017-12-19 Impact factor: 10.793
Authors: Meghan E McGarry; Elizabeth Castellanos; Neeta Thakur; Sam S Oh; Celeste Eng; Adam Davis; Kelley Meade; Michael A LeNoir; Pedro C Avila; Harold J Farber; Denise Serebrisky; Emerita Brigino-Buenaventura; William Rodriguez-Cintron; Rajesh Kumar; Kirsten Bibbins-Domingo; Shannon M Thyne; Saunak Sen; Jose R Rodriguez-Santana; Luisa N Borrell; Esteban G Burchard Journal: Chest Date: 2015-06 Impact factor: 9.410
Authors: Kathryn E Kyler; Jonathan Wagner; Chelsea Hosey-Cojocari; Kevin Watt; Valentina Shakhnovich Journal: Paediatr Drugs Date: 2019-10 Impact factor: 3.022
Authors: Mary Helen Black; Ning Smith; Amy H Porter; Steven J Jacobsen; Corinna Koebnick Journal: Obesity (Silver Spring) Date: 2012-01-17 Impact factor: 5.002