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Excess weight affects asthma drug response

Wednesday September 8th 2021

Children who are overweight or obese might be at a raised risk of asthma attacks due to reduced effectiveness of their medication, new research suggests.

The study used information on genetic variants linked to body mass index and their link to the response to inhaled corticosteroids (ICS).

Dr Cristina Longo of Amsterdam University Medical Centre, The Netherlands, and her team analysed information on 1.511 children using ICS for asthma, aged between two and 16, from five previous studies. One in five of the children were obese.

The information included genetic variants linked to BMI from DNA samples. A 'poor response' to medication was defined as one or more asthma attacks needing either urgent medical care or oral corticosteroids.

In their study, to be presented at the virtual European Respiratory Society International Congress today, the researchers write: "We consistently show that the proportion of children with poor ICS response more than doubled for each one unit increase in the BMI z-score.”

A one unit change in BMI z-score would take a child from healthy weight to 'at risk of being overweight', or from at risk to being overweight, or from overweight to obese.

Dr Longo said: “We know that children with asthma, whose symptoms are poorly controlled, tend to gain weight. This is possibly because they exercise less. Children with asthma who are overweight or obese are more likely to have worse symptoms despite being on the recommended treatment of inhaled corticosteroids."

She suggests: "At the very least, research identifying potential alternative treatments should be encouraged and prioritised. Clinicians need to take a more personalised approach to treating overweight and obese children."

Abstract no: OA4221 Cristina Longo et al. An international Mendelian Randomization study of BMI and ICS response in children. 8 September 2021 at the European Respiratory Society virtual International Congress.

[abstract]

Tags: Allergies & Asthma | Child Health | Europe | Pharmaceuticals

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