title: Comparative effect of body mass index on response to asthma controller therapy.
abstract: Increases in body mass index (BMI) are reported to influence asthma severity and response to treatment. This analysis was designed to explore whether increasing BMI altered the comparative response to treatment with either fluticasone propionate (FP) or montelukast. Two double-blind, randomized, parallel-group trials of 12-weeks duration comparing FP, 88 micrograms, twice daily or montelukast, 10 mg, daily were evaluated. Subjects with mild-moderate persistent asthma were retrospectively stratified by BMI of <20 kg/m(2) (underweight), 20-24.9 kg/m(2) (normal weight), 25-29.9 kg/m(2) (overweight), and > or =30 kg/m(2) (obese). Outcomes included mean changes in forced expiratory volume in 1 second (FEV(1)) and morning peak flow, daily albuterol use, and daily symptom scores. There were 1052 subjects evenly distributed between FP and montelukast by baseline parameters, including BMI. FP was statistically superior to montelukast for all BMI categories of normal, overweight, and obese subjects for FEV(1) (p < 0.008), morning peak flow (p < 0.002), albuterol use (p < 0.02), and symptom scores (p < 0.05). FP produced a significantly greater clinical response for normal, overweight, and obese subjects compared with montelukast. Irrespective of BMI, FP appears to be the more effective asthma controller therapy.
authors.affiliation: Department of Medicine, National Jewish Health, Denver, Colorado, USA.
authors.forename: E Rand
authors.initials: ER
authors.lastname: Sutherland
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Camargo
authors.forename: William W
authors.initials: WW
authors.lastname: Busse
authors.forename: Eli O
authors.initials: EO
authors.lastname: Meltzer
authors.forename: Hector G
authors.initials: HG
authors.lastname: Ortega
authors.forename: Steven W
authors.initials: SW
authors.lastname: Yancey
authors.forename: Amanda H
authors.initials: AH
authors.lastname: Emmett
authors.forename: David A
authors.initials: DA
authors.lastname: Stempel
mesh_terms: D000085:Acetates / Q000008:administration & dosage / Q000627:therapeutic use; D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000730:Androstadienes / Q000008:administration & dosage / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control; D015992:Body Mass Index; D003521:Cyclopropanes; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D000068298:Fluticasone; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000188:drug therapy; D050177:Overweight / Q000150:complications / Q000188:drug therapy; D011804:Quinolines / Q000008:administration & dosage / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013440:Sulfides; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000085:Acetates; D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D011804:Quinolines; D013440:Sulfides; D000068298:Fluticasone; C093875:montelukast