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Allergy and Airway |

Weight Loss Following Bariatric Surgery Reduces Need for Inhalers in Asthma

Randall Schwartz, MD; Marlow Hernandez, DO; Franck Rahaghi, MD; Jose Ramirez, MD; Raul Rosenthal, MD; Gustavo Ferrer, MD
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Cleveland Clinic Florida, Weston, FL


Chest. 2014;145(3_MeetingAbstracts):15A. doi:10.1378/chest.1824454
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Abstract

SESSION TITLE: Asthma Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: The cost of inhalers for asthma in the United States is about $15 billion annually. Obese patients with asthma use more inhalers compared to their nonobese counterparts. Asthma seen in obese patients differs from classical atopic asthma, and symptoms have been shown to improve with weight loss. We sought to examine the change in inhaler use among morbidly obese patients with asthma following bariatric surgery.

METHODS: This was a retrospective chart review and longitudinal cohort study of 716 morbidly obese patients. Inclusion criteria required body mass index (BMI) > 40 kg/m2, history of either gastric bypass surgery or sleeve gastrectomy, and diagnosis of asthma at time of surgery. The primary endpoint was percent change in the number of patients using inhalers at the point of maximum weight loss from date of surgery. Only patients with a diagnosis of asthma (by chart review) were included. Differences, before and after surgery, were analyzed using paired sample t-tests for continuous variables, and chi square for categorical variables.

RESULTS: We reviewed 605 patients with a diagnosis of asthma. The average change in BMI was -16.2 kg/m2. There was a decrease in the number of patients using short acting beta agonists (SABA) by 12.7% (p<0.0001), resulting in a number needed to treat (NNT) of 8 patients. There was a decrease in the number of patients using long acting beta agonist/inhaled corticosteroid combination (LABA/ICS) by 8.1% (p<0.004), resulting in a NNT of 12 patients. The number of patients using short- or long-acting muscarinic antagnonists (SABA, LAMA) decreased by 1.5% (p < 0.4). Overall, there was a 14.7% reduction (p < 0.05) in the number of patients using inhalers postoperatively with a NNT of 7 patients.

CONCLUSIONS: We concluded that weight loss via bariatric intervention probably reduces the need for inhalers in morbidly obese patients diagnosed with asthma.

CLINICAL IMPLICATIONS: Weight loss from bariatric surgery, in addition to its other health benefits, may lead to thousands of dollars saved on inhalers annually per patient with asthma.

DISCLOSURE: The following authors have nothing to disclose: Randall Schwartz, Marlow Hernandez, Franck Rahaghi, Jose Ramirez, Raul Rosenthal, Gustavo Ferrer

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