Body weight trajectory of non-obese asthmatics: Relationship with inhaled corticosteroids maintenance therapy

Background: It is unclear whether the continuous use of a high dose of inhaled corticosteroids (ICS) could contribute to an unfavorable trajectory in body weight. Objectives: The objective was to evaluate whether a high dose of ICS used continuously for maintenance therapy increases the risk of an unfavorable body weight trajectory in individuals with asthma and who are not obese. Methods: We screened consecutive individuals with chronic respiratory symptoms suggestive of asthma who underwent a medical consultation in any of the 42 public health facilities in the municipality of Jundiaí, Brazil. We included individuals with proven asthma who were ≥ 20 years of age and who had a body mass index (BMI) < 30 kg/m² on the day of screening for the study. Individuals participated in two study visits 12 months apart, named V₁ and V₂. Between study visits, individuals had one intermediate consultation with their referring physician. Results: Ninety-nine individuals used a high dose of ICS during the study and 294 used a low-medium dose. The individual with asthma and no obesity and who used a high dose of ICS had a similar risk of having obesity at V₂ compared with those who used a low-medium dose (adjusted odds ratio 1.18 [95% confidence interval, 0.46-3.04]). The probability of gaining weight was similar between the two groups. Conclusion: The use of a high dose of ICS for 1 year does not increase the risk of obesity among individuals with asthma and who are not obese, nor is it associated with an unfavorable body weight trajectory compared with individuals with asthma who were using a low-medium dose of ICS. This information may help reduce fears about using ICS.