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Gastric Drug Does Not Improve Asthma Control

Asymptomatic gastroesophageal reflux not a likely cause of poor asthma control

WEDNESDAY, April 8 (HealthDay News) -- Treating asymptomatic gastroesophageal reflux disease with a proton-pump inhibitor in patients with poorly controlled asthma does not improve asthma control, researchers report in the April 9 issue of the New England Journal of Medicine.

John G. Mastronarde, M.D., from Ohio State University Medical College in Columbus, and colleagues randomly assigned 412 patients with poorly controlled asthma and minimal or no gastroesophageal reflux symptoms to 40 mg of esomeprazole (a proton-pump inhibitor) twice a day, or a matching placebo.

Over 24 weeks, the researchers found that esomeprazole did not improve asthma control compared with placebo (2.5 and 2.3 events per person-year, respectively). Esomeprazole also had no effect on secondary outcomes, including pulmonary function, airway reactivity and quality of life. In addition, the 40 percent of patients with gastroesophageal reflux (documented by pH monitoring) did not benefit from esomeprazole treatment, the report indicates.

"Despite a high prevalence of asymptomatic gastroesophageal reflux among patients with poorly controlled asthma, treatment with proton-pump inhibitors does not improve asthma control," Mastronarde and colleagues conclude. "Asymptomatic gastroesophageal reflux is not a likely cause of poorly controlled asthma."

AstraZeneca supplied the study drug and placebo. Several authors reported consulting and financial relationships with pharmaceutical companies, including AstraZeneca.

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