Risk for exacerbations, hospitalization higher in patients w
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Patients with adult-onset asthma and long-term obesity had more asthma exacerbations and respiratory-related hospitalizations compared with patients with normal weight at diagnosis over 12 years of follow-up, researchers reported.

Obesity has been associated with poor outcomes of asthma in cross-sectional studies but long-term effect of obesity on asthma remains unknown.

This study aimed to study the effects of obesity, found at the time of diagnosis of adult-onset asthma, on 12-year prognosis by focusing on oral corticosteroid (OCS) use and respiratory-related hospital admissions.

Patients diagnosed with adult-onset asthma (n=203) were divided into three categories based on diagnostic BMI (less than 25, 25–29.9, more than 30 kg·m2) and followed for 12-years as part of Seinäjoki Adult Asthma Study. Self-reported and dispensed OCS were assessed for the 12-year period. Data on hospital admissions were analyzed based on medical records.

Results:
-- 12 years after diagnosis, of the patients obese (more than 30 kg·m2) at diagnosis, 86% remained obese.

-- During the follow-up, no difference was found in the weight gain between the BMI categories.

-- During the 12-year follow-up, patients obese at diagnosis reported more often use of OCS courses (46.9% versus 23.1%), were dispensed OCS more often (81.6% versus 56.9%) and at higher doses (median 1350 (IQR 280–3180)mg versus 600 (0–1650)mg prednisolone) compared to normal-weight patients.

-- Furthermore, obese had more often more than 1 respiratory-related hospitalization compared to normal-weight patients (38.8% versus 16.9%.

-- In multivariate logistic regression analyses, obesity predicted oral corticosteroid use and hospital admissions.

Conclusively, in adult-onset asthma, patients obese at diagnosis mostly remained obese at long-term and had more exacerbations and respiratory-related hospital admissions compared to normal-weight patients during 12-year follow-up. Weight loss should be a priority in their treatment to prevent this outcome.

Source: https://erj.ersjournals.com/content/early/2020/09/28/13993003.01209-2020
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