- Title
- Asthma medication use in obese and healthy weight asthma: systematic review/meta-analysis
- Creator
- Thompson, Cherry A.; Eslick, Shaun R.; Berthon, Bronwyn S.; Wood, Lisa G.
- Relation
- European Respiratory Journal Vol. 57, Issue 2021, no. 2000612
- Relation
- https://erj.ersjournals.com/content/57/3/2000612
- Publisher
- European Respiratory Society
- Resource Type
- journal article
- Date
- 2021
- Description
- Background Obesity is a common comorbidity in asthma and associated with poorer asthma control, more frequent/severe exacerbations, and reduced response to asthma pharmacotherapy. Objective This review aims to compare use of all classes of asthma medications in obese (body mass index (BMI) ⩾30 kg·m−2) versus healthy-weight (BMI <25 kg·m−2) subjects with asthma. Design Databases including CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, Embase and MEDLINE were searched up to July 2019 for English-language studies that recorded medication use or dose in obese and healthy-weight adults with asthma. A critical appraisal checklist was utilised for scrutinising methodological quality of eligible studies. Meta-analysis was performed and heterogeneity was examined with the use of the Chi-squared test. This review was conducted based on a published protocol (www.crd.york.ac.uk/PROSPERO CRD42020148671). Results Meta-analysis showed that obese subjects are more likely to use asthma medications, including short-acting β2-agonists (OR 1.75, 95% CI 1.17–2.60; p=0.006, I2=41%) and maintenance oral corticosteroids (OR 1.86, 95% CI 1.49–2.31; p<0.001, I2=0%) compared to healthy-weight subjects. Inhaled corticosteroid (ICS) dose (µg·day−1) was significantly higher in obese subjects (mean difference 208.14, 95% CI 107.01–309.27; p<0.001, I2=74%). Forced expiratory volume in 1 s (FEV1) % predicted was significantly lower in obese subjects (mean difference −5.32%, 95% CI −6.75–−3.89; p<0.001, I2=42%); however, no significant differences were observed in FEV1/forced vital capacity (FVC) ratio between groups. Conclusions We found that obese subjects with asthma have higher use of all included asthma medication classes and higher ICS doses than healthy-weight asthma subjects, despite lower FEV1 and a similar FEV1/FVC %. A better understanding of the factors driving increased medication use is required to improve outcomes in this subgroup of asthmatics.
- Subject
- asthma; obesity; treatment; medication; asthma pharmacotherapy; asthma therapy; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1461105
- Identifier
- uon:46107
- Identifier
- ISSN:0903-1936
- Language
- eng
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