Long-term prognosis of new adult-onset obese asthma

Abstract

Background: Obesity has been associated with poor outcomes of asthma in cross-sectional studies but long-term effect of obesity on asthma remains unknown. Aims: To study effects of obesity found at diagnosis of asthma on 12-year prognosis of adult-onset asthma by focusing on use of oral corticosteroids and respiratory-related hospital admissions. Methods: Patients diagnosed with adult-onset asthma (n=203) were divided into three groups based on diagnostic BMI ( Results: 12 years after diagnosis, of the patients obese (≥30kg/m2) at diagnosis, 86% remained obese and there was no difference in the weight gain between the BMI groups. During the 12-year follow-up, patients obese at diagnosis reported more often use of oral steroid courses (46.9% vs 23.1%, p=0.028), were dispensed oral corticosteroids more often (81.6% vs 56.9%, p=0.014) and at higher doses (median 1350 (IQR 280-3180)mg vs 600 (0-1650)mg prednisolone, p=0.010) compared to normal-weight patients. Furthermore, obese had more often ≥1 respiratory-related hospital admission compared to normal-weight patients (38.8% vs 16.9%, p=0.033). In multivariate logistic regression analyses, diagnostic obesity predicted oral corticosteroid use and hospital admissions. Conclusions: In adult-onset asthma, patients obese at diagnosis most often 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 priority in their treatment to prevent this outcome.