The German Asthma Net: Weight loss predictors in severe asthma with obesity or overweight

Weight loss is an essential aspect of treatment in patients with severe asthma and comorbid obesity or overweight. However, the predictors for successful weight loss have not been elucidated to date, particularly in this important patient group.

This longitudinal study assesses baseline predictors of weight loss of≥5% body weight at a follow-up of (mean±SD) 14.8±11.2 months in 782 patients with BMI≥25 kg/m² of the German Asthma Net (GAN), an international, multi-centre, and real-life registry, through ANOVA, Kruskal-Wallis, and Chi-Square tests. No structured weight loss program was applied.

A weight loss of≥5% body weight was associated with significantly less exacerbations per year at baseline (p=0.002), and a lower rate of frequent exacerbations (p=0.006). A third of the patients who achieved weight loss had no exacerbations at baseline, compared to a fifth of patients who gained weight or remained stable (p=0.001).

Weight loss of≥5% body weight was also significantly associated with more frequent biologics use at baseline (p<0.001), as well as high-dose inhaled corticosteroids (p=0.043). Weight loss was further associated with female sex (p=0.001), higher BMI (p=0.02), and LAMA treatment (p=0.005). Intriguingly, weight loss was not significantly associated with oral corticosteroid use, asthma control, or quality of life at baseline (all p>0.05).

Conclusively, relevant predictors of weight loss in patients with severe asthma and overweight or obesity were lower exacerbation rates, use of biologics, and high-dose inhaled corticosteroid and LAMA treatment. Importantly, good asthma control or quality of life were not a prerequisite for weight loss.

Publication History

Article published online:
18 March 2025