Contemporary management techniques of asthma in obese patients

ABSTRACT

Introduction: Obesity-associated asthma represents a heterogeneous group of clinical phenotypes, including an adult-onset phenotype. These patients often have difficult to control symptoms and often are less likely to respond to conventional asthma therapies.

Areas covered: This review covers the effects of lifestyle interventions, including diet and weight loss, effect asthma outcomes and how obesity-associated asthma responds to conventional approaches to asthma management.

Expert opinion: Management of obesity-associated asthma should include lifestyle modifications aimed at weight reduction, management of other co-morbidities, and limiting systemic steroids. As many of these patients have non-Th2 asthma, long-acting muscarinic antagonists and macrolides may be potentially helpful. Medications to treat metabolic syndrome.

KEYWORDS:

• Asthma
• obesity
• treatment
• oxidative stress
• diet

Article highlights

• Obesity increases asthma incidence and leads to poorer asthma control.

• Weight loss, through dietary intervention or surgery, appears to improve quality of life.

• Management of metabolic syndrome may improve asthma outcomes.

• Conventional asthma medications are less effective in obesity-associated asthma.

• Medications that are effective in non-Th2 asthma, including LAMA and macrolides, may be effective in adult-onset obesity-associated asthma.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was funded by the U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute (HL146542-01)