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Overweight/obesity status in preschool children associates with worse asthma but robust improvement on inhaled corticosteroids.

Publication ,  Journal Article
Lang, JE; Fitzpatrick, AM; Mauger, DT; Guilbert, TW; Jackson, DJ; Lemanske, RF; Martinez, FD; Strunk, RC; Zeiger, RS; Phipatanakul, W; Tang, M ...
Published in: J Allergy Clin Immunol
April 2018

BACKGROUND: Overweight/obesity (OW) is linked to worse asthma and poorer inhaled corticosteroid (ICS) response in older children and adults. OBJECTIVE: We sought to describe the relationships between OW and asthma severity and response to ICS in preschool children. METHODS: This post hoc study of 3 large multicenter trials involving 2- to 5-year-old children compared annualized asthma symptom days and exacerbations among normal weight (NW) (body mass index: 10th-84th percentiles) versus OW (body mass index: ≥85th percentile) participants. Participants had been randomized to daily ICS, intermittent ICS, or daily placebo. Simple and multivariable linear regression was used to compare body mass index groups. RESULTS: Within the group not treated with a daily controller, OW children had more asthma symptom days (90.7 vs 53.2, P = .020) and exacerbations (1.4 vs 0.8, P = .009) thanNW children did. Within the ICS-treated groups, OW and NW children had similar asthma symptom days (daily ICS: 47.2 vs 44.0 days, P = .44; short-term ICS: 61.8 vs 52.9 days, P = .46; as-needed ICS: 53.3 vs 47.3 days, P = .53), and similar exacerbations (daily ICS: 0.6 vs 0.8, P = .10; short-term ICS: 1.1 vs 0.8 days, P = .25; as-needed ICS: 1.0 vs 1.1, P = .72). Compared with placebo, daily ICS in OW led to fewer annualized asthma symptom days (90.7 vs 41.2, P = .004) and exacerbations (1.4 vs 0.6, P = .006), while similar protective ICS effects were less apparent among NW. CONCLUSIONS: In preschool children off controller therapy, OW is associated with greater asthma impairment and exacerbations. However, unlike older asthmatic patients, OW preschool children do not demonstrate reduced responsiveness to ICS therapy.

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Published In

J Allergy Clin Immunol

DOI

EISSN

1097-6825

Publication Date

April 2018

Volume

141

Issue

4

Start / End Page

1459 / 1467.e2

Location

United States

Related Subject Headings

  • Overweight
  • Obesity
  • Male
  • Humans
  • Female
  • Disease Progression
  • Child, Preschool
  • Body Mass Index
  • Asthma
  • Anti-Asthmatic Agents
 

Citation

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Lang, J. E., Fitzpatrick, A. M., Mauger, D. T., Guilbert, T. W., Jackson, D. J., Lemanske, R. F., … National Institutes of Health/National Heart, Lung and Blood Institute AsthmaNet, . (2018). Overweight/obesity status in preschool children associates with worse asthma but robust improvement on inhaled corticosteroids. J Allergy Clin Immunol, 141(4), 1459-1467.e2. https://doi.org/10.1016/j.jaci.2017.09.043
Lang, Jason E., Anne M. Fitzpatrick, David T. Mauger, Theresa W. Guilbert, Daniel J. Jackson, Robert F. Lemanske, Fernando D. Martinez, et al. “Overweight/obesity status in preschool children associates with worse asthma but robust improvement on inhaled corticosteroids.J Allergy Clin Immunol 141, no. 4 (April 2018): 1459-1467.e2. https://doi.org/10.1016/j.jaci.2017.09.043.
Lang JE, Fitzpatrick AM, Mauger DT, Guilbert TW, Jackson DJ, Lemanske RF, et al. Overweight/obesity status in preschool children associates with worse asthma but robust improvement on inhaled corticosteroids. J Allergy Clin Immunol. 2018 Apr;141(4):1459-1467.e2.
Lang, Jason E., et al. “Overweight/obesity status in preschool children associates with worse asthma but robust improvement on inhaled corticosteroids.J Allergy Clin Immunol, vol. 141, no. 4, Apr. 2018, pp. 1459-1467.e2. Pubmed, doi:10.1016/j.jaci.2017.09.043.
Lang JE, Fitzpatrick AM, Mauger DT, Guilbert TW, Jackson DJ, Lemanske RF, Martinez FD, Strunk RC, Zeiger RS, Phipatanakul W, Bacharier LB, Pongracic JA, Holguin F, Cabana MD, Covar RA, Raissy HH, Tang M, Szefler SJ, National Institutes of Health/National Heart, Lung and Blood Institute AsthmaNet. Overweight/obesity status in preschool children associates with worse asthma but robust improvement on inhaled corticosteroids. J Allergy Clin Immunol. 2018 Apr;141(4):1459-1467.e2.
Journal cover image

Published In

J Allergy Clin Immunol

DOI

EISSN

1097-6825

Publication Date

April 2018

Volume

141

Issue

4

Start / End Page

1459 / 1467.e2

Location

United States

Related Subject Headings

  • Overweight
  • Obesity
  • Male
  • Humans
  • Female
  • Disease Progression
  • Child, Preschool
  • Body Mass Index
  • Asthma
  • Anti-Asthmatic Agents