Heartburn pills won't help asthma symptoms: study
There's no point for people with asthma to take powerful acid reflux drugs when they aren't suffering from heartburn, because it won't help their asthma symptoms and could cause side-effects, doctors say.
In silent gastroesophageal reflux disease, or GERD, acid or food rises up into the throat from the stomach, causing minimal or no symptoms of heartburn.
It was thought that asthma and GERD were related, and symptoms often overlap.
About half of people with asthma who also have reflux have no symptoms. Acid reflux causes airways in the lungs to constrict, and the narrowing of the airways can induce acid reflux, researchers said.
In the New England Journal of Medicine, doctors reported the results of a trial of 402 people with poorly controlled asthma.
Half of the participants took a prescription heartburn medication called proton pump inhibitors meant to reduce stomach acid and ulcers.
Asthma symptoms were no better among those taking the heartburn pills compared with people taking sugar pills twice a day for six months, the researchers said.
"We found 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," said the study's lead investigator, Dr. John Mastronarde, a critical care and lung specialist at Ohio State's Medical Center.
"This research is especially important because, by determining which patients do not need the additional medication, we are saving them unnecessary costs, potential side-effects and the risk of interactions with other drugs," he added in a release.
Based on the findings, study co-author Dr. Robert Wise of Johns Hopkins University's medical school said doctors no longer need to test for GERD in people with asthma unless the patients reports symptoms of acid reflux.
In a journal editorial accompanying the study, Drs. Koichiro Asano and Hidekazu Suzuki of Keio University School of Medicine in Tokyo recommended that a study be done comparing surgical repair of gastroesophageal reflux with medication in asthma patients with reflux, noting there could still be a relationship between the two conditions.
People with asthma who are taking reflux medications and don't have heartburn should talk to their doctor about going off the proton pump inhibitors, suggested Dr. Elizabeth Nabel, director of the U.S. National Heart, Lung and Blood Institute.
Asthma affects an estimated 2.7 million adults and children, according to Health Canada.
The institute and the American Lung Association funded the study. AstraZeneca LLP, the maker of Nexium, provided the pills used in the trial. Several of the study's authors and the editorial writers reported receiving lecture and consulting fees from makers of asthma medications.