PPIs Don't Ease Asthma Symptoms in Children with Severe Asthma and Asymptomatic GERD

Gastroesophageal reflux disease (GERD) is more common in children with asthma than in children without asthma, but whether the association is causal is uncertain. Nonetheless, patients with uncontrolled asthma and no reflux symptoms are often given proton-pump inhibitors (PPIs) despite unproven benefit. To examine the effect of PPIs on asthma control in children, researchers randomized 306 children (age range, 6–17 years) with poorly controlled asthma and no reflux symptoms to receive lansoprazole or placebo in addition to inhaled corticosteroid treatment for 24 weeks; of 115 children who underwent esophageal pH monitoring, 43% had asymptomatic GERD.

The mean change in Asthma Control Questionnaire score (the primary outcome) and secondary me…