WASHINGTON, D.C. | A commonly used acid reflux medication does not improve asthma control, according to a paper published by the American Lung Association Asthma Clinical Research Centers.

Using proton pump inhibitors for hard-to-control asthma is recommended in U.S. guidelines as a last-ditch effort, said study author Dr. Nicholas Anthonisen of the University of Manitoba, but not in Canadian asthma guidelines.

Though their use in Canada “varies widely from place to place,” Dr. Anthonisen said, “it’s not uncommon.”

The study randomized 412 patients with poorly controlled asthma to receive either placebo or 40 mg of the proton pump inhibitor esomeprazole, which is designed to treat gastroesophageal reflux disease (GERD), a condition that is common in asthmatics and has been thought to worsen asthma symptoms. Patients in the study had either minor or no symptoms of GERD.

During the 24-week study period, patients kept asthma diaries, underwent spirometry testing every four weeks and answered questionnaires about asthma symptoms. The researchers also conducted pH testing to determine whether patients had GERD.

No improvement
The study found esomeprazole did not improve asthma control, which was similar in both groups. Patients in the placebo group experienced 201 asthma events compared with 224 in esomeprazole patients (2.3 events per person year compared with 2.5 events per person year, respectively). There were also no statistically significant difference in the number of urgent-care visits, use of rescue medications or night wakings between the two groups.

Dr. Anthonisen said the study shows it’s not worthwhile to test patients for GERD if the ultimate goal is to improve asthma control.

“To try to solve an asthma problem by giving proton pump inhibitors in a patient in whom they are not otherwise indicated is not useful,” he said.

The study was published in the April 9 issue of the New England Journal of Medicine.