Twenty-four weeks of lansoprazole reduces asthma exacerbations and improves asthma quality of life in subjects with symptoms of acid reflux
M. R. Littner, D. Ballard, B. Huang, N. K. Samra (Sepulveda, Lake Forest, Abbott Park, United States Of America)
Source: Annual Congress 2002 - Asthma: Inflammation, hyperreactivity, treatment side effects
Disease area: Airway diseases
Abstract Introduction : Asthma patients often associate symptoms of acid reflux with increased symptoms of asthma. Acid suppressive therapy has been inconsistent in improving pulmonary function and asthma symptoms.Methods : 207 subjects with usual asthma care were randomized (double-blind) to 30 mg bid of a proton pump inhibitor, lansoprazole (Prevacid®), or placebo. Subjects had acid reflux symptoms, moderate to severe persistent asthma, FEV1 of 50 to 85% predicted, were on inhaled steroids and not on routine acid suppressive therapy. All other asthma medications were allowed. Patients were well matched to age, asthma and reflux symptoms, quality of life (QOL) (Juniper, Thorax 47:76, 1992), FEV1 , peak flow, and asthma medications. Outcomes included asthma diary symptoms, QOL, FEV1 , daily peak flow, albuterol use, and asthma exacerbations.Results : At 24 weeks, there was improvement in the QOL emotions domain (mean change ±] SE of 1.0 ±] 0.14 vs 0.6 ±] 0.15 units, p=0.025) and there were fewer subjects with at least 1 asthma exacerbation (8 vs 22, p=0.017) with lansoprazole compared to placebo. There was an increase in evening peak flow (13.2 ±] 2.9 vs 4.2 ±] 3.0 L/m, p=0.033) in the placebo group. Lansoprazole significantly improved reflux symptoms. Lansoprazole subjects had more treatment-related diarrhea (6% vs 0%). From baseline to Week 24, post-albuterol FVC increased in the lansoprazole group (mean [SD] of 3.55 [0.86] vs 3.61 [0.87], p=0.035). 15 placebo and 4 lansoprazole subjects required prednisone for exacerbations.Conclusions : The daily use of lansoprazole reduces asthma exacerbations and improves general well being of asthma patients with symptoms of acid reflux.
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M. R. Littner, D. Ballard, B. Huang, N. K. Samra (Sepulveda, Lake Forest, Abbott Park, United States Of America). Twenty-four weeks of lansoprazole reduces asthma exacerbations and improves asthma quality of life in subjects with symptoms of acid reflux. Eur Respir J 2002; 20: Suppl. 38, 428
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