SUNDAY, March 4 (HealthDay News) -- Overweight children may not
respond as well to common asthma medicines known as inhaled
corticosteroids, new research finds.
As a result, they may need more of the long-term control
medication, said researcher Dr. Pia Hauk, an assistant professor of
pediatrics at National Jewish Health, in Denver.
"In our patient population, and we see a lot of severe asthmatics, the overweight and obese children have about twice as high an inhaled corticosteroid requirement than those of a healthy weight," Hauk said.
The study was small, including just 61 children with asthma,
aged 2 to 18, so the results should not be considered
conclusive.
Thirty-four children were at healthy weights, 13 were overweight
and 14 obese. Most of the kids, 56, used inhaled
corticosteroids.
The researchers noted each child's weight and body-mass index
(BMI) -- a measurement based on height and weight -- and daily
asthma medication dosage.
They also cultured blood and airway cells, and evaluated the
cells' response to asthma medicine, looking at a specific gene that
affects the medication response.
Hauk found that as the weight and BMI rose, the drug response
decreased. The gene was not expressed as much in overweight
children, she said.
The findings were slated for presentation Sunday at the American
Academy of Allergy, Asthma & Immunology annual meeting in
Orlando, Fla.
About 9 million U.S. children under age 18 have been diagnosed
with asthma at some point in their lives, according to the academy.
Inhaled corticosteroids, which help reduce airway inflammation and
mucus production, have been used for more than 50 years. They
include beclomethasone (Qvar), triamcinolone (Azmacort) and
mometasone (Asmanex).
About 17 percent of U.S. children and teens are obese, with a
BMI over 30, according to the U.S. Centers for Disease Control and
Prevention. That's triple the rate of a generation ago. Obese
children are more likely to get asthma than normal-weight
children.
Hauk speculates that chronic inflammation, which is seen in
obesity, may interfere with the body's response to the
medicine.
Dr. Sherry Farzan, an allergist and immunologist at North
Shore-LIJ Health System, in Great Neck, N.Y., said that other
research has shown that overweight adults with asthma had a lower
response to their medicines.
"This study is looking more at a cellular level" than some other studies, she said, noting that it lends weight to previous findings.
Hauk said more study is needed before recommending asthma
medication changes for overweight children. Until more research is
in, parents might encourage their child to lose excess weight, she
said.
"We know that obesity and being overweight in children is not good in general," Hauk said. "By reducing weight you may decrease inflammation, and you may become more responsive to corticosteroid therapy again."
Data and conclusions presented at medical meetings should be
considered preliminary until published in a peer-reviewed medical
journal.
More information
To learn more about asthma medication, visit the
American Academy of Allergy Asthma &
Immunology.