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 Vol. 22 No. 1, July 2009
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AAP Grand Rounds 22:2 (2009)
© 2009 American Academy of Pediatrics

SENIORS

PPIs for Adults with Poorly Controlled Asthma Not Beneficial

Source: The American Lung Association Asthma Clinical Research Centers. Efficacy of esomeprazole for treatment of poorly controlled asthma. N Engl J Med. 2009;360(15):1487–1499; doi:10.1056.NEJMoa0806290[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.


PICO

Question: In patients with poorly controlled asthma, can treatment of asymptomatic gastroesophageal reflux improve asthma control?

Question type: Intervention

Study design: Randomized, double-blind, controlled trial

 

Investigators from multiple institutions in the US and Canada conducted a randomized controlled trial to determine whether proton-pump inhibitors (PPI) can improve symptoms in adults with poorly controlled asthma who have no prior history of significant gastroesophageal reflux (GER). Study participants were recruited from 19 clinical centers between 2004 and 2008.

Inclusion criteria included an age of 18 years or greater; a diagnosis of asthma by a physician and a confirmation of the diagnosis with a positive methacholine challenge or documentation of a 12% increase in the FEV1 after the use of a bronchodilator; at least eight weeks of stable use of an inhaled corticosteroid; and poor asthma control as defined as a score of 1.5 or higher on the Jupiter Asthma Control Questionnaire, a validated measure . . . [Full Text of this Article]

Donald Schiff, MD, FAAP
University of Colorado School of Medicine and The Children’s Hospital, Aurora, CO