The children were randomly assigned to receive either lansoprazole -- a PPI -- or a placebo daily for six months. The dose of lansoprazole was based on the child's weight.
Asthma improvement was assessed through a change in the Asthma Control Questionnaire, which has a scale of 0 to 6. A change of 0.5 is considered clinically significant. Lung function was also measured.
After six months, there were no statistically significant differences between the groups. The average change in the Asthma Control Questionnaire score was only 0.2, and there were no statistically significant changes in lung function, quality of life or rate of asthma flare-ups.
In addition, among 115 children who also had a 24-hour esophageal acid study, 43 percent were found to have elevated levels of acid production. Yet even in this group, treatment with lansoprazole didn't improve asthma symptoms over placebo.
Holbrook said although this study only looked at one PPI, she believes the results would hold true for other medications in this class of drugs.
Children taking lansoprazole had about a 30 percent higher risk of respiratory infections and sore throats in this study. PPIs were also associated with a difference in the risk of activity-related bone fractures, although the difference was not statistically significant, according to an accompanying editorial in the same issue of the journal.
"PPIs do not improve asthma in children who do not have symptoms of GER/GERD, and it is unlikely to be of great benefit even in children who do have such symptoms," said the editorial author, Dr. Fernando Martinez, director of the Arizona Respiratory Center at the University of Arizona in Tucson.
"The substantial increase in use of PPIs in children during the last decade is worrisome and unwarranted," he wrote.
Still, Martinez advised parents not to abruptly discontinue any medications. Parents "sho
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