Asthma medication usage is significantly reduced following bariatric surgery

• Published in: Surgical endoscopy Vol. 33; no. 6; pp. 1967 - 1975
• Main Authors: Guerron, Alfredo D., Ortega, Camila B., Lee, Hui-Jie, Davalos, Gerardo, Ingram, Jennifer, Portenier, Dana
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2019; Springer Nature B.V
• Subjects: 2018 SAGES Oral; Abdominal Surgery; Adult; Anti-Asthmatic Agents - therapeutic use; Asthma; Asthma - drug therapy; Asthma - physiopathology; Asthma - prevention & control; Bariatric Surgery - methods; Body Mass Index; Female; Gastroenterology; Gastroesophageal reflux; Gastrointestinal surgery; Gynecology; Hepatology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity; Obesity, Morbid - complications; Obesity, Morbid - surgery; Proctology; Respiratory therapy; Retrospective Studies; Surgery; Weight Loss - physiology; Obesity; Medications; Bariatric surgery; Asthma
• ISSN: 0930-2794; 1432-2218; 1432-2218
• DOI: 10.1007/s00464-018-6500-x

Introduction Asthma is an important healthcare problem affecting millions in the United States. Additionally, a large proportion of patients with asthma suffer from obesity. These patients exhibit poor asthma control and reduced therapy response, increasing utilization of healthcare resources. Pulmonary symptoms improve after bariatric surgery (BS), and we hypothesized that asthma medication usage would decrease following BS. Methods A retrospective data analysis was performed in adult patients from a single institution’s database. Patients with obesity using at least one asthma medication pre-operatively who underwent BS were studied for up to 3-years post-operation. Poisson generalized linear mixed models for repeated measures were used to evaluate the effects of time and procedure type on the number of asthma medication. Results Bariatric patients with at least one prescribed asthma medication (mean 1.4 ± 0.6) were included ( n  = 751). The mean age at time of operation was 46.8 ± 11.6 years, mean weight was 295.9 ± 57 lbs, and mean body mass index (BMI) was 49 ± 8.2 kg/m 2 ; 87.7% were female, 33.4% had diabetes, 44.2% used gastroesophageal reflux disease (GERD) medication, and 64.4% used hypertension medication. The most common procedure was Roux-en-Y gastric bypass (79%), followed by sleeve gastrectomy (10.7%), adjustable gastric banding (8.1%), and duodenal switch (2.3%). The mean number of prescribed asthma medications among all procedures decreased by 27% at 30 days post-operation ( p  < 0.0001), 37% at 6 months ( p  < 0.0001), 44% at 1 year ( p  < 0.0001), and 46% at 3 years ( p  < 0.0001) after adjusting for risk factors. No significant differences in medication use over time between procedure types were observed. In the adjusted analysis, the mean number of asthma medications was 12% higher in patients using at least one GERD medication ( p  = 0.015) and 8% higher with 10-unit increase in pre-operative BMI ( p  = 0.006). Conclusion BS significantly decreases asthma medication use starting 30 days post-operation with a sustained reduction for up to 3 years.