@article {Ilmarinen2001209, author = {Pinja Ilmarinen and Adrienn Pardo and Leena E. Tuomisto and Iida V{\"a}h{\"a}talo and Onni Niemel{\"a} and Pentti Nieminen and Hannu Kankaanranta}, title = {Long-term prognosis of new adult-onset asthma in obese patients}, volume = {57}, number = {4}, elocation-id = {2001209}, year = {2021}, doi = {10.1183/13993003.01209-2020}, publisher = {European Respiratory Society}, abstract = {Background Obesity has been associated with poor outcomes of asthma in cross-sectional studies, but long-term effect of obesity on asthma remains unknown.Aims To study the effects of obesity, found at the time of diagnosis of adult-onset asthma, on 12-year prognosis by focusing on oral corticosteroid (OCS) use and respiratory-related hospital admissions.Methods Patients diagnosed with adult-onset asthma (n=203) were divided into three categories based on diagnostic body mass index (BMI) (\<25 kg{\textperiodcentered}m-2, 25{\textendash}29.9 kg{\textperiodcentered}m-2, >=30 kg{\textperiodcentered}m-2) and followed for 12 years as part of the Sein{\"a}joki Adult Asthma Study. Self-reported and dispensed OCS were assessed for the 12-year period. Data on hospital admissions were analysed based on medical records.Results 12 years after diagnosis, 86\% of the patients who were obese (BMI >=30 kg{\textperiodcentered}m-2) at diagnosis remained obese. During the follow-up, no difference was found in weight gain between the BMI categories. During the 12-year follow-up, patients obese at diagnosis reported more frequent use of OCS courses (46.9\% versus 23.1\%, p=0.028), were dispensed OCS more often (81.6\% versus 56.9\%, p=0.014) and at higher doses (median 1350 (interquartile range 280{\textendash}3180) mg versus 600 (0{\textendash}1650) mg prednisolone, p=0.010) compared to normal-weight patients. Furthermore, patients who were obese had more often one or more respiratory-related hospitalisations compared to normal-weight patients (38.8\% versus 16.9\%, p=0.033). In multivariate logistic regression analyses, obesity predicted OCS use and hospital admissions.Conclusions In adult-onset asthma, patients obese at diagnosis mostly remained obese at long-term and had more exacerbations and respiratory-related hospital admissions compared to normal-weight patients during 12-year follow-up. Weight loss should be a priority in their treatment to prevent this outcome.Obese patients with new adult-onset asthma often remain obese in the long-term and have more exacerbations and respiratory-related hospital admissions during follow-up. High priority should be given to weight loss during treatment to prevent this outcome. https://bit.ly/2G5HtRZ}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/57/4/2001209}, eprint = {https://erj.ersjournals.com/content/57/4/2001209.full.pdf}, journal = {European Respiratory Journal} }