Asthma and gastro-oesophageal reflux: can the response to anti-reflux therapy be predicted?
The aim of the study was to investigate which features predict favourable response to omeprazole therapy in asthmatics with gastro-oesophageal reflux (GER). The study population consisted of 52 outpatient asthmatics with GER who had completed an intervention where they were randomized to receive omeprazole 40 mg once a day or placebo for 8 weeks. After a 2-week washout period the patients were crossed over. Asthma symptoms were found to be relieved > or = 20% in 18 (35%) patients who were thus regarded as responders. A logistic regression analysis was performed in order to identify which features separate the responders from the non-responders. More responders were found among the patients whose body mass index (BMI) was higher (P = 0.02) or whose distal esophageal reflux was more severe [total time (%) pH < 4 (P = 0.01) or time (%) pH < 4 in upright position (P = 0.04)]. Adding other predictors to the total time (%) pH < 4, which was the most significant predictor for response in multi-variate analysis, did not further increase the prediction for favourable outcome. It is concluded that severe distal oesophageal reflux and obesity predict amelioration in asthma symptoms after 8-week omeprazole treatment in asthmatics with GER. Adding more than one predictor does not seem to further increase prediction for favourable asthma response.
Kiljander
T
T
Department of Pulmonary Diseases, Turku University Central Hospital, Finland. toni.kiljander@utu.fi
Salomaa
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ER
Hietanen
E
E
Helenius
H
H
Liippo
K
K
Terho
E O
EO
D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001249:Asthma / Q000150:complications* / Q000188:drug therapy; D015992:Body Mass Index; D016001:Confidence Intervals; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D009853:Omeprazole / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D009853:Omeprazole