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Asthma Meds Less Effective in Overweight
Friday December 5, 2008

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Glucocorticoids, better known as steroids and the primary controller medication for asthma, are 40% less effective in overweight and obese asthma patients than in those of normal weight, National Jewish Health in Denver reports.

The study "should spur doctors to carefully evaluate response to treatment in overweight and obese asthmatics. ... We also hope they will spur additional research into the treatment of obese patients with asthma," the American Thoracic Society quoted E. Rand Sutherland, MD, MPH, in its American Journal of Respiratory and Critical Care Medicine.

National Jewish measured 45 nonsmoking adults, 33 of whom had asthma, for the response of cells and the lungs to the steroid dexamethasone, which interferes with inflammation. It raised levels of a key molecule against inflammation by 5.27 times in the cells of lean patients, but only 3.11 times in those who were overweight or obese. Yet that negative relationship between weight and response to steroids did not occur in participants who did not have asthma, Sutherland said.

A longer-term study to evaluate the clinical effects of steroid resistance among overweight and obese asthma patients is under way, he said.

It is important to note," Sutherland said, that inhaled steroids are still effective in the nearly one-half of all asthmatics with a body mass index greater than 25, and that they should discuss concerns with their physician if they believe medication is not working rather than stopping it or increasing dosage.



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