A proton pump inhibitor, lansoprazole, ameliorates asthma symptoms in asthmatic patients with gastroesophageal reflux disease.
Aspiration of acid to the airway causes airway inflammation, and acid stress to the airway caused by gastroesophageal reflux disease (GERD) has been known as a potential mechanism of deteriorated asthma symptoms. However, the efficacy of the acid suppressive drugs, H(2)-receptor blockers (H(2) blocker) and proton pump inhibitors, on asthma symptoms and pulmonary functions remains controversial. We therefore designed the randomized prospective study to determine the efficacy of an H(2) blocker (roxatidine, 150 mg/day) and a proton pump inhibitor (lansoprazole, 30 mg/day) on asthma symptoms of 30 asthmatic patients with GERD. These patients were divided in the two groups (15 patients for each group) and treated with either roxatidine or lansoprazole. The diagnosis of GERD was established by the method of Los Angeles classification including mucosal minimum change of Grade M and questionnaire for the diagnosis of reflux disease (QUEST) score. The efficacy of acid suppressive drugs was evaluated by peak expiratory flow (PEF), asthma control questionnaire (ACQ) that evaluates the improvement of asthma symptoms, and forced expiratory volume in 1 second (FEV(1.0)). Lansoprazole, but not roxatidine, significantly improved PEF and ACQ scores (p < 0.05) with the improved QUEST scores. However, these acid suppressive drugs did not change the pulmonary function of FEV(1.0) in asthmatic patients. In conclusion, treatment with a proton pump inhibitor, lansoprazole, appears to be useful in improvement of asthma symptoms in asthmatic patients with GERD.
Shimizu
Yasuo
Y
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan. yasuos@med.gunma-u.ac.jp
Dobashi
Kunio
K
Kobayashi
Setsuo
S
Ohki
Ichiro
I
Tokushima
Masahiko
M
Kusano
Motoyasu
M
Kawamura
Osamu
O
Shimoyama
Yasuyuki
Y
Utsugi
Mitsuyoshi
M
Sunaga
Noriaki
N
Ishizuka
Tamotsu
T
Mori
Masatomo
M
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D004341:Drug Evaluation; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D010880:Piperidines / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D054328:Proton Pump Inhibitors; D011795:Surveys and Questionnaires
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D010880:Piperidines; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D009853:Omeprazole; C053742:roxatidine acetate