Even though steroid treatment is one of the most commonly recommended treatment options for asthma, yet bodies of some children may show no response to such treatment. This finding was disclosed by a new study presented at the American Thoracic Society.

It was suggested that some children may respond well while others may achieve no benefit at all with steroids, as per Gregory Sawicki, M.D. of Children’s Hospital in Boston.

From News-Medical.Net:

“The majority of children with mild asthma are less likely to have symptoms as they get older and may not need to be on daily steroids,” Dr. Sawicki said. “The flip side is that if a child has poor asthma control, the parents and doctor need to make sure the child is adhering to their inhaled steroid treatment. But variation in response to inhaled steroids, as other medications, is well described.”

The data comes from the Child Asthma Management Program Continuation Study (CAMPCS), one of the largest groups of children with mild to moderate asthma in the nation who have been followed over 10 years. “This study gives us a good sense of real-world practice in asthma management,” Dr. Sawicki says. “The children’s care is not directed by anyone in the study; it’s an observation of what goes on when the children’s care is directed by their own physicians.”

It was further noted by Sawicki that asthma control cannot be managed even if higher doses of steroids were administered to non-responsive children, much like all adult asthmatic patients do not derive benefit from steroids.

Tags:  asthma, asthma treatment, inhaled corticosteroids, inhaled steroids

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According to a study by researchers from the National Jewish Health, being overweight or obese does not put asthma patients under any greater risk than their leaner counterparts though obese asthmatic patients may be slower in relation to medication response.

As per lead author E. Rand Sutherland, Associate Professor of Medicine at National Jewish Health, an improvement in asthmatic condition may not necessarily happen from loss of weight. It was also remarked by the lead author that obese patients may be slower than their leaner counterparts to respond to inhaled corticosteroids, which are the most popular asthma controller medications.

From News-Medical.Net:

Dr. Sutherland and his colleagues decided to examine the issue in a well characterized group of 1,256 patients who had participated in NIH-sponsored studies. They divided them into patients with a body mass index of less than 25 (lean) and greater than or equal to 25 (overweight and obese). They found that lean asthma patients had slightly greater forced expiratory volume in one second, or FEV1 (3.05 liters vs 2.91 liters), and slightly greater ratio of FEV1 to forced vital capacity (83.5% vs. 82.4%), both common measures of lung function. They also found slightly greater use of rescue inhalers among overweight patients (1.2 puffs per day vs. 1.1 puffs per day) and slightly higher scores asthma-relate quality of life questionnaires (5.77 vs. 5.59).

“These differences were small and are unlikely to be of any real clinical significance,” said Dr. Sutherland.

Response to medications, however, did show an effect of increased weight. Among a subgroup of 183 people, lean patients taking inhaled corticosteroids alone showed a 55% greater reduction in exhaled nitric oxide, a measure of inflammation. Lean patients taking a combination inhaled steroid and long-acting beta agonist increased their FEV1 by 80 more milliliters. There were no differences, however, between these patients in the number of asthma exacerbations.

“The data suggest overweight and obese people respond less well to controller medications for asthma than do their lean counterparts,” said Dr. Sutherland. “These data come from already-completed studies designed to answer other questions, however, and ongoing studies are being conducted to more definitively determine the effect of increased weight on treatment response in asthma.”

The study, however, was not sure how and why an increased body weight did not intervene in worsening asthma.

Tags:  asthma, asthmatic patients, inhaled corticosteroids, medication for asthma, obese asthma patients

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