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Millions With Asthma Don’t Need PPIs

Acid Reflux Treatment Has Little Impact, Study Says

Asthma and Acid Reflux continued...

The study participants were randomly assigned to either twice-daily treatment with a widely prescribed PPI drug or a placebo for six months in addition to asthma treatment. During this time, they kept diaries to track their asthma symptoms, and they underwent monthly lung function testing.

Patients who took a PPI and those who did not showed no significant difference in asthma symptoms over the course of the six-month study. They also had similar self-reported quality-of-life scores.

Outcomes were similar among subgroups of patients who would be expected to benefit most from PPI treatment, such as those with silent GERD and those with nighttime awakening from asthma symptoms.

Pulmonologist and lead investigator John Mastronarde, MD, of Ohio State University Medical Center, tells WebMD that the findings should have an immediate impact on asthma treatment.

“The practice of prescribing a PPI to patients without heartburn is probably not something that I will do anymore,” he says.

Children May Still Benefit

It is not clear how many patients fall into that category, but Mastronarde and Wise say that many millions of adults with asthma in the U.S. may be taking acid reflux drugs for no good reason.

PPIs are also commonly prescribed to children with poorly controlled asthma. A similarly designed, NHLBI-funded trial is now under way to determine if treating silent GERD in children improves their asthma symptoms.

“Kids are not small adults, and it may very well be that treatment (with a PPI) is beneficial,” Mastronarde says.

Wise points out that because a child’s esophagus is shorter than an adult’s, it is easier for stomach fluids to back up into the throat and reach the lungs.

For this reason, children may benefit from acid reflux drugs even though adults do not.

“We don’t want children who might be on this treatment to stop it without reason,” Wise says.

In addition to the NHLBI, the American Lung Association provided funding support for the study.

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