2nd Edition of International Obesity and Metabolism Conference 2026

Abstract

Background:
Obesity-related asthma is a distinct phenotype characterized by non-allergic inflammation, reduced responsiveness to corticosteroids, and worse clinical outcomes, particularly in women. The interplay between sex hormones, obesity, and asthma remains poorly understood, yet emerging evidence suggests that oral contraceptive pills (OCPs) may influence airway inflammation. Given the high prevalence of OCP use among reproductive-aged women, understanding their role in modulating asthma severity. The aim of this study was to map and evaluate existing evidence on the influence of oral contraceptive use on airway inflammation and clinical outcomes in obese women with asthma, and to identify gaps for future research.

Methods:
A scoping review was conducted following the PRISMA-ScR guidelines. Databases including PubMed, Scopus, Embase, Web of Science, and Cochrane Library will be searched for peer-reviewed literature from the last 15 years. Inclusion criteria: studies involving female asthma patients, reporting on oral contraceptive or hormonal contraceptive use, with outcomes related to airway inflammation (e.g., sputum neutrophils/eosinophils, FeNO, lung function, exacerbations). Both observational and interventional studies will be included.

Results
The review found that oral contraceptives (OCPs) have BMI-dependent effects on asthma in women. In non-obese individuals, OCPs were linked to reduced airway inflammation and lower asthma risk, likely due to estrogen’s anti-inflammatory effects. In contrast, these benefits were weakened or reversed in obese women, where metabolic dysfunction (e.g., leptin resistance) may disrupt hormonal pathways. Clinically, OCPs were associated with fewer exacerbations in non-obese women, but neutral or negative outcomes in obesity-related asthma. Key gaps include limited data on different OCP formulations and their impact on non-neutrophilic inflammation or airway remodeling.

Conclusion
OCPs may improve airway inflammation in non-obese asthmatics, but show reduced benefit in obese women due to metabolic-hormonal interference. Their role in obesity-related asthma remains unclear. Future studies should focus on adipose-hormone interactions and tailored OCP therapies. A precision medicine approach is essential for hormonal treatment decisions in asthma care.