Source: International Congress 2015 – New data on established treatments for asthma and COPD
Disease area: Airway diseases

Abstract

OBJECTIVES: Very few studies demonstrated that b-2 adrenergic agonists reduce "Lower Esophageal Sphincter”pressure in healthy volunteers and asthma patients, but their effects have not been studied at rescue dosage for asthma patients. We aimed to investigate potential effects of salbutamol on esophageal mechanics. METHODS: Phase 4, prospective clinical trial. Seventeen asthma patients with frequent GERD symptoms underwent HRM with 36 solid-state pressure sensors(MMS,The Netherlands). After exclusion two of them due to hiatal-hernia, LES-relaxation(IRP),esophagus-length(EL),contractile-front-velocity(CFV),distal-latency(DL),upper&lower sphincter pressures(UESP&LESP) metrics were measured at rest, after 10x5 ml water intake, following multiple rapid swallow. Measurements were taken after different respiratory maneuvers before/after inhalation of salbutamol 400 mcg for once.RESULTS:Most of patients were female(n=14,93%),mean age was 51±4.8(38-65).Mean IRP,CFV,DL values were measured as 914±571mmHg.sn.cm, 4.4±3cm/sn and 7.1±1 respectively. There were no statistically significant differences among UESP,LESP,EL during respiratory maneuvers before and after salbutamol inhalation. A significant decrease was observed in UESP with salbutamol after deep inspirium (94±61vs62±42 respectively)(p=0.04) CONCLUSIONS:Decrease in UESP might be related with direct topical effect of the inhaler. Tendency to fall, but not a significant decrease in LESP might be interpretedas;salbutamol, at least at this rescue-low dosage, might not responsible from a refluxogenic effect as suggested previously by the literature.


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Özlem Göksel (Izmir, Turkey), Ozlem Goksel, Rukiye Vardar, Haydar S. Karakus, Yasemin Alev, Esra Yildirim, Munevver Erdinc, Serhat Bor. The effects of inhaler B-2 adrenergic agonists on esophaeal high resolution manometry pressure metrics in asthma patients with inadequate symptom control (Ege University reflux group). Eur Respir J 2015; 46: Suppl. 59, 1011

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