Heavy Kids May Not Respond as Well to Asthma Meds

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.

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