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American Lung Association Study to be Published in the 'New England Journal of Medicine' Finds Prescription Heartburn Medication Does Not Control Asthma Symptoms as Previously Thought
Date:4/8/2009

tantially improve asthma control.

Methods: 402 asthmatics with inadequate asthma control despite inhaled corticosteroids and absent or minimal GER symptoms were randomly assigned to either esomeprazole 40 mg b.i.d. or matching placebo in a parallel-group double-masked clinical trial. Participants were followed for 24 weeks with daily asthma diaries, every 4-week spirometry, and asthma symptom questionnaires.

Participants were classified with respect to GER status with ambulatory pH probe monitoring. The primary outcome was the rate of episodes of poor asthma control (EPACs) based on asthma diaries.

Results: Episodes of poor asthma control occurred with similar frequency in the placebo and esomeprazole treatment groups (2.3 vs. 2.5 events/person-year, respectively, P=0.66). There was no treatment effect with respect to components of the EPACs, or secondary outcomes including pulmonary function, airways reactivity, asthma control, symptom scores, nocturnal awakenings, or quality of life. GER documented by pH probe studies in 40% of participants with absent or minimal symptoms did not identify a subgroup benefiting from PPI treatment. Serious adverse events were fewer with esomeprazole than placebo (11 vs. 17).

Conclusion: Despite a high prevalence of asymptomatic GER in patients with poorly controlled asthma, treatment with proton pump inhibitors does not improve control. Silent GER is not a likely cause of poorly controlled asthma.

Norman H. Edelman, MD, disclosed stock ownership with Johnson & Johnson.

About the American Lung Association: Now in its second century, the American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease. With your generous support, the American Lung Association is "Fighting for Air" through research, education and advocacy. For more informa
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SOURCE American Lung Association
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