Treating heartburn or gastroesophageal reflux (GERD) in patients without any symptoms of GERD is not an effective way to control asthma, according to a study preformed by the the American Lung Association Asthma Clinical Research Centers and published in the New England Journal of Medicine. The study determined that the coughing, wheezing and breathlessness associated with poorly controlled asthma are not improved by treatment for GERD in asthmatic patients without GERD symptoms.
Patients with poorly controlled asthma and symptomatic GERD are treated with anti-reflux medications like Prilosec, Prevacid or Nexium with some associated improvement in their asthma. But for asthma patients with "silent GERD" there appears to be no benefit in taking GERD medications, the new study shows.
John Mastronarde, a clinical associate professor of medicine at Ohio State University, and colleagues performed a randomized controlled trial where poorly controlled asthma patients without GERD symptoms received either the drug esomeprazole, a proton pump inhibitor, or a placebo to determine if asymptomatic GERD could be a cause of poorly controlled asthma and if treating asymptomatic GERD was of any clinical benefit.
The study found no differences in the number of episodes of poor asthma control, lung function tests, or other symptoms such as nighttime awakenings or quality of life.
In a press release, Mastronade concludes "that ‘silent’ GERD is likely not the cause of poorly controlled asthma, and treatment with proton pump inhibitors does not improve control or provide any benefit to the patients.”
Norman H. Edelman, Chief Medical Officer for the American Lung Association, commented in their press release that "each year, people with asthma are spending as much as $10 million dollars on prescription heartburn medication believing it will help control attacks of wheezing, coughing, and breathlessness." He went on to say "now we know with confidence that silent acid reflux does not play a significant role in poor asthma control."
While this study does not have impact treatment for asthmatic patients with symptomatic GERD,patients being treated for asymptomatic GERD may want to discuss the continued benefit of reflux treatment with their asthma care provider.
