National study results change common method of treating asthma

Apr 8 2009

A nationwide study of adults with asthma reveals no benefit for treatment for silent acid reflux, which long has been thought to be the culprit for some severe asthma symptoms such as coughing, wheezing and breathlessness.

The findings, which could save $10 million annually in unwarranted prescriptions, are reported in the April 9 issue of the New England Journal of Medicine.

The American Lung Association's Asthma Clinical Research Centers found the longstanding practice of prescribing heartburn medication to be ineffective for asthma patients who do not exhibit the symptoms of acid reflux such as heartburn or stomach pain.

"The results of this study will change the treatment of asthma," said Michael Busk, M.D., MPH, associate professor of medicine at the Indiana University School of Medicine and director of the Indiana University Asthma Clinical Research Center at the National Institute for Fitness and Sport (IU ACRC at NIFS). "Not only will the findings result in medical care savings but, more importantly, they will improve asthma care for millions of patients."

The IU ACRC at NIFS had the second largest number of participants in the study nationwide with 28 of the 400 study participants.

Patients participating in the ACRC study were randomly given either 80 milligrams of esomeprazole or placebo. Patients in both groups had similar reports of poor asthma control episodes so there were no measurable differences in their lung function or other asthma symptoms. The results showed that prescription acid control medication were not more effective than placebo for the treatment of asthma.

"East year, people with asthma are spending as much as $10 million on prescription heartburn medications believing it will help control attacks of wheezing, coughing and breathlessness," said Norma H. Edelman, M.D. American Lung Association chief medical officer. "Now we know with confidence that silent acid reflux doesn't play a significant role in poor asthma control. Talk with your doctor before discontinuing any medication, as each patient's specific needs will vary."

The American Lung Association recommends that people with asthma and symptoms of gastric reflux, such as heartburn that occurs at least twice a week, check with their physician about taking medicine to control reflux.

Astra Zeneca provided the medication for the study that was funded by the American Lung Association and the National Heart, Lung and Blood Institute, part of the National Institutes of Health.

Other members of the IU ACRC at NIFS participating in the national study were Frederick Leickly, M.D., Paula Puntenney, R.N, M.A., Janet Hutchins, R.N., Carolyn Magnes, M.S., Mary Circle and Nancy Busk, M.S.

Dr. Busk said that the IU ACRC at NIFS now is participating in a similar study for children with asthma. For additional information on ongoing studies at the IU ACRC at NIFS, call 317-278-ACRC.