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Title: Anti-Reflux Therapy Improves Asthma Symptoms But Not Lung Function
URL: http://www.pslgroup.com/dg/8D6A6.htm
Doctor's Guide
July 8, 1998


NORTHBROOK, IL -- July 8, 1998 -- The treatment of gastroesophageal reflux (GER) disease in asthmatics may reduce asthma symptoms and reduce the need for asthma medication but has minimal or no effect on lung function, according to a new report in this month's issue of CHEST, the journal of the American College of Chest Physicians.

The report, carried out by Drs. Stephen Field and Lloyd Sutherland of the University of Calgary in Alberta, was based on a review of 171 English-language, peer-reviewed studies involving 326 patients. The object was to measure the effectiveness of anti-reflux therapy as indicated in the study findings. The association between gastroesophageal reflux (GER) and asthma has been reported in the literature during the past 35 years, the authors said.

Symptomatic GER is known to be about four to five times more prevalent in patients with asthma than in other patient groups. Hiatial hernia and esophagitis are also more prevalent in asthmatics.

The authors reported that of the 171 English-language studies, only 12 were published on anti-reflux medication in asthmatics with GER. Within these 12, they added, comparison of findings was difficult because of differences in study design and the fact that different medications and doses were used over a 15-year period. However, they said, the inclusion of studies using different regimens was justified by the fact that the outcomes were so similar.

The analysis of the combined data showed that of asthma patients with GER who were treated with anti-reflux therapy:

-- asthma symptoms improved in 69 percent
-- asthma medication dose was reduced in 62 percent
-- evening peak expiratory flow improved in 25 percent
-- spirometry (in any of the placebo-controlled studies) did not improve.

Drs. Fields and Sutherland found the findings surprising.

"The challenge for future investigators will be to explain the paradox of the strong association between GER and asthma and between improvement in asthma symptoms with anti-reflux therapy and the absence of demonstrable changes in lung function," they write, adding it remains to be determined which asthmatics will benefit from anti-reflux therapy.

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