Body mass index and response to asthma therapy: fluticasone propionate/salmeterol versus montelukast

J Asthma. 2010 Feb;47(1):76-82. doi: 10.3109/02770900903338494.

Abstract

We studied the relationship between body mass index (BMI) on responses to asthma therapy using a retrospective analysis of four previously reported clinical trials. Fluticasone propionate (FP)/salmeterol via Diskus 100/50 microg twice daily and montelukast (MON) 10 mg daily were compared. BMI was classified as underweight (less than 20 kg/m(2)), normal (20-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), obese-1 (30-34.9 kg/m(2)), obese-2 (35-39.9 kg/m(2)), or obese-3 (at least 40 kg/m(2)). Outcomes assessed included forced expiratory volume in one second (FEV(1)), asthma symptom score, and albuterol use. FP/salmeterol produced greater improvements compared to MON in each of the asthma outcomes studied over the entire BMI range at the week-12 endpoint, with statistically significant differences noted among normal, overweight, obese-1, and obese-3 subjects. The within-treatment responses to FP/salmeterol across BMI ranges at the week-12 endpoint was statistically significantly greater in normal compared to obese-3 for FEV(1) and albuterol use, and in overweight compared to the obese-3 for each outcome studied. The within-treatment comparisons of MON across BMI ranges were significant for albuterol use in normal and underweight compared to obese-3 at the week-12 endpoint. Compared to subjects with normal BMI, the onset to peak FEV(1) may require longer treatment exposure in the very obese. Treatment responses to FP/salmeterol were consistently greater compared to MON and persisted at higher BMI.

Publication types

  • Meta-Analysis

MeSH terms

  • Acetates / pharmacology
  • Acetates / therapeutic use*
  • Adult
  • Albuterol / analogs & derivatives*
  • Albuterol / pharmacology
  • Albuterol / therapeutic use
  • Androstadienes / pharmacology
  • Androstadienes / therapeutic use*
  • Anti-Asthmatic Agents / pharmacology
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / complications*
  • Asthma / diagnosis
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Body Mass Index*
  • Double-Blind Method
  • Drug Combinations
  • Female
  • Fluticasone-Salmeterol Drug Combination
  • Forced Expiratory Volume / drug effects
  • Forced Expiratory Volume / physiology
  • Humans
  • Male
  • Middle Aged
  • Multicenter Studies as Topic
  • Obesity / complications
  • Obesity / pathology
  • Overweight / complications
  • Overweight / pathology
  • Quinolines / pharmacology
  • Quinolines / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Time Factors
  • Treatment Outcome

Substances

  • Acetates
  • Androstadienes
  • Anti-Asthmatic Agents
  • Drug Combinations
  • Fluticasone-Salmeterol Drug Combination
  • Quinolines
  • montelukast
  • Albuterol