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A 1-Year Weight Management Program for Difficult-to-Treat Asthma With Obesity: A Randomized Controlled Study.

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  • 1School of Infection and Immunity, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom; Glasgow Royal, Clinical Research Facility, Glasgow, United Kingdom.

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The Counterweight-Plus Programme (CWP) led to significant weight loss and improved asthma quality of life in obese patients. While not all asthma control measures improved, the program shows promise for managing obesity-associated asthma.

Keywords:
asthmaasthma remissiondifficult-to-treat asthmaobesitysevere asthmaweight management

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Area of Science:

  • Pulmonology and Respiratory Medicine
  • Obesity Medicine
  • Clinical Trial Research

Background:

  • Obesity significantly increases morbidity and mortality in asthma patients.
  • Effective weight management strategies are crucial for treating difficult-to-treat asthma in obese individuals.

Purpose of the Study:

  • To evaluate the 1-year asthma outcomes of the Counterweight-Plus Programme (CWP) versus usual care (UC) in patients with difficult-to-treat asthma and obesity.
  • To determine if the CWP improves asthma control and quality of life compared to UC.

Main Methods:

  • A single-center, randomized controlled trial involving adults with difficult-to-treat asthma and BMI ≥ 30 kg/m².
  • Participants were randomized to either the CWP (dietitian-supported weight management) or UC.
  • Outcomes assessed included the Asthma Control Questionnaire (ACQ-6), Asthma Quality of Life Questionnaire (AQLQ), and health care usage over 52 weeks.

Main Results:

  • The CWP group achieved significantly greater weight loss (-14 kg) compared to the UC group (+2 kg) at 52 weeks.
  • A higher proportion of CWP participants achieved the minimal clinically important difference (MCID) in AQLQ (71% vs. 6%).
  • While no between-group difference in ACQ-6 was observed, 70% of the CWP group losing ≥10% body weight showed improvements in both ACQ-6 and AQLQ.

Conclusions:

  • Dietitian-supported weight management via the CWP leads to sustained weight loss and is a potential treatment for obesity in asthma.
  • The CWP demonstrated a significant improvement in asthma quality of life compared to usual care.
  • Further large-scale studies are warranted to confirm these encouraging findings on asthma-related outcomes.