Bariatric Surgery Helps Relieve Asthma Symptoms
In a recent retrospective chart review and longitudinal cohort study, a 14.7% reduction in the number of patients using inhalers for the treatment of asthma, post bariatric surgery was observed.
The study focused on 605 morbidly obese patients meeting the following criteria: a body mass index (BMI) > 40 kg/m2, a history of gastric bypass surgery or sleeve gastrectomy, and diagnosis of asthma at the time of surgery. The change in inhaler usage in patients from the date of surgery to the point of maximum weight loss was analyzed using paired sample t-tests for continuous variables and chi square tests for categorical variables.
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The average change in BMI of the 605 patients was -16.2 kg/m2. There was a decrease in the number of patients using short acting beta agonists and long acting beta agonists/inhaled corticosteroid combination by 12.7% and 8.1%, respectively. The number of patients using short- and long-acting muscarinic antagonists decreased by 1.5%.
According to Dr. Randall Schwartz, chief internal medicine resident at the Cleveland Clinic in Weston, Florida, while there was an observed decrease in inhaler usage, 10% of patients required more inhaler therapy after surgery. Only 203 patients, however, had formal pulmonary function tests (PFT) and 9 patients had fractional exhaled nitric oxide measured. Dr. Schwartz explains, "I think nitric oxide would be a really non-invasive and simple thing we could do to follow-up with these patients because PFTs represent a bit of a challenge in this population because of body mechanics."
The researchers concluded bariatric intervention reduces the need for inhalers in morbidly obese patients diagnosed with asthma and consequently, may result in thousands of dollars saved on inhalers per patient with asthma.
— Sarah O’Brien
References
Schwartz R, Hernandez M, Rahaghi F, et al. Weight Loss Following Bariatric Surgery Reduces Need for Inhalers in Asthma. Chest. 2014;145(3); MeetingAbstracts.
Bariatric surgery sliced asthma inhaler use [press release]. http://www.internalmedicinenews.com/single-view/bariatric-surgery-sliced-asthma-inhaler-use/82b10240bf8702a4c18984cdbfa2aa5f.html