Are Proton-Pump Inhibitors Beneficial for Patients with Poorly Controlled Asthma?

Because acid reflux can cause bronchoconstriction, NIH asthma guidelines state the following: “For patients who have poorly controlled asthma . . . investigation for GERD may be warranted even in the absence of suggestive symptoms.”

To determine whether treatment of occult acid reflux is worthwhile for asthma patients, 412 adults with inadequately controlled asthma were randomized to receive the proton-pump inhibitor (PPI) esomeprazole (40 mg twice daily) or placebo. Reasoning that patients who have highly symptomatic gastroesophageal reflux disease — with or without asthma — would receive acid-suppressive therapy anyway, researchers excluded patients who required medication for heartburn more than once weekly. On ambulatory pH monitoring, 4…