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Heartburn Drug May Relieve Severe Asthma

Benefits of Prevacid confined to those taking several asthma drugs

MONDAY, Oct. 21, 2002 (HealthDayNews) -- People suffering from severe asthma as well as acid reflux disease might find the medicine they take for the reflux provides some crossover relief for their breathing problems.

In a double-blind, six-month study of 207 asthma and acid reflux sufferers, those patients who took daily acid-reducing medicine along with their asthma medicine had fewer severe asthma attacks and an improvement in their quality of life, says Dr. Michael Littner, a professor of medicine at University of California in Los Angeles and the study's lead author.

"Those patients with asthma and acid reflux symptoms who were taking two maintenance medicines, such as inhaled corticosteroids and long-acting beta-2 agonists, for asthma as well as lansoprazole had a significant, clinically important improvement," says Littner, who reported the findings today at the American College of Gastroenterology's annual meeting in Seattle.

Lansoprazole is a category of drug called a proton pump inhibitor (PPI), which inhibits the production of stomach acid and is used in treating acid reflux disease. Tap Pharmaceutical Products Inc. manufactures lansoprazole under the name Prevacid, and was the sponsor of the study.

The benefits, Littner says, were that those on lansoprazole reported fewer severe asthma attacks, called exacerbations, than did those who took a placebo.

"In the emotions domain of the questionnaires they filled out, they reported a better sense of general well-being," he adds.

The improvements, though, were seen only in those with severe asthma, which was defined in the study as patients who took more than one long-term maintenance medication for their disease. Study participants who took only one asthma medicine showed no improvement in their asthma with the lansoprazole.

Dr. Timothy Wang, chief of gastroenterology at the University of Massachusetts Medical School, says asthma and gastroesophageal reflux disease (GERD) seem to be closely linked, with each one leading to the worsening of the other. He also says there may be a small subgroup of asthma patients who are helped by taking acid inhibitors, but most patients will show no benefit.

While this study has the advantage of being a randomized, double-blind study, he says "since all these patients had acid reflux disease in addition to asthma, they should have been taking the acid reflux medicine anyway, regardless of their asthma."

Littner responds that the study participants had not been taking PPIs on a daily basis before the study. Asthma sufferers who were already taking daily PPI medication were not included in the study because if they were getting relief, the doctors did not want to take them off their medicines and put them on a placebo.

"The patients in the study were those who thought their heartburn was being controlled by occasional antacids. When they were having a pizza, they'd take an antacid, or maybe a PPI, but normally did not take daily medications for reflux symptoms," he says.

In the 24-week study, 207 regular asthma patients, recruited from 32 medical centers throughout the country, were divided into two groups -- one taking 30 milligrams daily of Prevacid, and the other taking a placebo. About half of the patients took more than one asthma medication, and they were divided equally between the Prevacid and placebo groups.

What To Do

A fact sheet about asthma can be found at the American Lung Association. The National Digestive Diseases Information Clearing House has equally thorough information about gastroesophageal reflux disease.

SOURCES: Michael R. Littner, M.D., pulmonary physician, Veterans Administration Greater Los Angeles Healthcare System, Sepulveda, Calif., and professor, medicine, David Geffen School of Medicine, University of California, Los Angeles; Timothy Wang, M.D., chief, gastroenterology, University of Massachusetts Medical School, Worcester, Mass.; Oct. 21, 2002, presentation, American College of Gastroenterology annual meeting, Seattle
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