Uncontrolled asthma in school-aged children—a nationwide specialist care study

Stridsman, Caroline; Martinsen, Øyvind; Selberg, Stina; Ödling, Maria; Konradsen, Jon R.

doi:10.1016/j.jacig.2024.100227

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…Consistent with epidemiological data, cluster analyses of adult asthmatics of varying nationalities have identified distinct clusters of either T H 2 high or low asthmatics who are obese and predominately female [ 19 – 26 ]. In addition to increasing the prevalence and incidence of asthma in children and adults, obesity increases asthma severity and decreases quality of life and asthma control [ 27 – 32 ]. Underscoring the continued global increase in obesity and its impact on asthma morbidity, Liu et al [ 33 ] reported that the number of asthma DALYs in overweight and obese individuals increased by 63.91% from 1990 to 2019.…”

Section: Introductionmentioning

confidence: 99%

Weighted Breaths: Exploring Biologic and Non-Biologic Therapies for Co-Existing Asthma and Obesity

Pilkington,

Buragamadagu,

Johnston

2024

Curr Allergy Asthma Rep

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Purpose of Review To discuss the effectiveness of biologics, some of which comprise the newest class of asthma controller medications, and non-biologics in the treatment of asthma co-existing with obesity. Recent Findings Our review of recent preliminary and published data from clinical trials revealed that obese asthmatics respond favorably to dupilumab, mepolizumab, omalizumab, and tezepelumab, which are biologics currently indicated as add-on maintenance therapy for severe asthma. Furthermore, clinical trials are ongoing to assess the efficacy of non-biologics in the treatment of obese asthma, including a glucagon-like peptide-1 receptor agonist, a Janus kinase inhibitor, and probiotics. Summary Although many biologics presently indicated as add-on maintenance therapy for severe asthma exhibit efficacy in obese asthmatics, other phenotypes of asthma co-existing with obesity may be refractory to these medications. Thus, to improve quality of life and asthma control, it is imperative to identify therapeutic options for all existing phenotypes of obese asthma.

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Section: Introductionmentioning

confidence: 99%

Weighted Breaths: Exploring Biologic and Non-Biologic Therapies for Co-Existing Asthma and Obesity

Pilkington,

Buragamadagu,

Johnston

2024

Curr Allergy Asthma Rep

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Obesity and Asthma: Implementing a Treatable Trait Care Model

Mendes,

Garcia‐Larsen,

Moreira

2024

Clin Experimental Allergy

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Recognition of obesity as a treatable trait of asthma, impacting its development, clinical presentation and management, is gaining widespread acceptance. Obesity is a significant risk factor and disease modifier for asthma, complicating treatment. Epidemiological evidence highlights that obese asthma correlates with poorer disease control, increased severity and persistence, compromised lung function and reduced quality of life. Various mechanisms contribute to the physiological and clinical complexities observed in individuals with obesity and asthma. These encompass different immune responses, including Type IVb, where T helper 2 cells are pivotal and driven by cytokines like interleukins 4, 5, 9 and 13, and Type IVc, characterised by T helper 17 cells and Type 3 innate lymphoid cells producing interleukin 17, which recruits neutrophils. Additionally, Type V involves immune response dysregulation with significant activation of T helper 1, 2 and 17 responses. Finally, Type VI is recognised as metabolic‐induced immune dysregulation associated with obesity. Body mass index (BMI) stands out as a biomarker of a treatable trait in asthma, readily identifiable and targetable, with significant implications for disease management. There exists a notable gap in treatment options for individuals with obese asthma, where asthma management guidelines lack specificity. For example, there is currently no evidence supporting the use of incretin mimetics to improve asthma outcomes in asthmatic individuals without Type 2 diabetes mellitus (T2DM). In this review, we advocate for integrating BMI into asthma care models by establishing clear target BMI goals, promoting sustainable weight loss via healthy dietary choices and physical activity and implementing regular reassessment and referral as necessary.

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Uncontrolled asthma in school-aged children—a nationwide specialist care study

Cited by 2 publications

References 27 publications

Weighted Breaths: Exploring Biologic and Non-Biologic Therapies for Co-Existing Asthma and Obesity

Weighted Breaths: Exploring Biologic and Non-Biologic Therapies for Co-Existing Asthma and Obesity

Obesity and Asthma: Implementing a Treatable Trait Care Model

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