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

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.