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A study published April 8, 2009 in the New England Journal of Medicine contradicts a long-held belief that severe asthma symptoms such as coughing, wheezing and breathlessness are triggered in part by acid reflux. Experts believe that the longstanding practice of prescribing heartburn medication is ineffective and unnecessarily expensive for asthma patients who do not exhibit symptoms associated with acid reflux such as heartburn or stomach pain.
The study was conducted by the American Lung Association's Asthma Clinical Research Centers (ACRC), including UC San Diego's Clinical Trials Center team.
"This is a definitive study," said Joe Ramsdell, MD, Director, UC San Diego Clinical Trials Center (CTC); Director, Division of General Internal Medicine-Geriatrics; and Professor of Clinical Medicine at UC San Diego School of Medicine. "We've shown that while a lot of asthma patients have acid reflux, taking medicine to control those symptoms doesn't do much for their asthma symptoms."
Patients participating in the American Lung Association's ACRC study were randomly given either 80 milligrams of esomeprazole (Nexium) or placebo. Patients in both groups had similar numbers of poor asthma control episodes, and there were no differences in their lung function or other asthma symptoms. These results show that esomeprazole was no more effective than placebo for the treatment of asthma.
The results of this study, published in the New England Journal of Medicine, are considered to be the most comprehensive evaluation to date of the efficacy of prescription heartburn medication to control respiratory flare-ups in asthmatics whose symptoms have not been well controlled by other therapies.
"Each year, people with asthma are spending as much as $10 million dollars on prescription heartburn medication believing it will help control attacks of wheezing, coughing and breathlessness," said Norman H. Edelman, MD, American Lung Association Chief Medical Officer. "Now we know with confidence that silent acid reflux does not play a significant role in poor asthma control. Talk with your doctor before discontinuing any medication, as each patient's specific needs will vary."
For asthma patients with symptoms of gastric reflux such as heartburn that occurs at least twice weekly, the American Lung Association recommends prescription heartburn medication be taken to control heartburn, and not asthma symptoms.
The drug's manufacturer, AstraZeneca provided the medication for the study that was funded by the American Lung Association and the National Heart, Lung and Blood Institute, a component of the National Institutes of Health.
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