Effect of weight change on asthma-related health outcomes in patients with severe or difficult-to-treat asthma

Objective: To evaluate the effects of weight change on asthma control, asthma-related quality of life, number of steroid bursts, and exacerbation of asthma symptoms in a population of adult patients with severe or difficult-to-treat asthma who participated in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study. Methods: We categorized 2396 TENOR patients >18 years into three groups (>= 5 lb loss, stable, >= 5 lb gain), based on a +/- 5 lb (2.27 kg) difference between baseline and 12-month follow-up weight. We used proportional odds and Logistic regression models to evaluate the effect of weight change on Asthma Therapy Assessment Questionnaire (ATAQ) and Asthma Quality of Life Questionnaire (AQLQ) scores, exacerbations, and steroid bursts at the 12-month follow-up. Results: Asthma patients who gained >= 5 [b (2.27 kg) during the 12-month interval between baseline and follow-up reported poorer asthma control (adjusted odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.01-1.49; p = 0.04), worse quality of life (Least square means: -0.18; 95% CI: -0.30 to -0.06; p = 0.003), and a greater number of steroid bursts (OR: 1.31; CI: 1.04-1.66; p = 0.02) than patients who maintained their baseline weight or lost >= 5 lb (2.27 kg). Conclusion: Increased weight is associated with worse asthma-related health outcomes. Strategies to prevent weight gain could help patients achieve better asthma control and improve asthma-related quality of life. (C) 2008 Elsevier Ltd. All rights reserved.