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Lansoprazole for children with poorly controlled asthma: a randomized controlled trial
JAMA
|January 26, 2012
Summary
Proton pump inhibitor lansoprazole did not improve asthma control in children with poorly controlled asthma and no overt GER symptoms. The medication did not improve asthma symptoms or lung function and increased respiratory infections.
Area of Science:
- Pediatric Pulmonology
- Gastroenterology
Background:
- Asymptomatic gastroesophageal reflux (GER) is common in children with asthma and may contribute to poor asthma control.
- The efficacy of proton pump inhibitors (PPIs) in improving asthma control in children without overt GER symptoms is not well-established.
Purpose of the Study:
- To evaluate the effectiveness of lansoprazole in improving asthma control in children with poorly controlled asthma but without overt GER symptoms.
Main Methods:
- A randomized, masked, placebo-controlled trial (The Study of Acid Reflux in Children With Asthma) involving 306 children with poorly controlled asthma on inhaled corticosteroids.
- Participants received either lansoprazole or placebo for 24 weeks.
- Asthma Control Questionnaire (ACQ) score was the primary outcome; lung function and quality of life were secondary outcomes.
Main Results:
- Lansoprazole did not significantly improve ACQ scores compared to placebo (mean difference 0.2 units).
- No significant differences were observed in lung function, asthma-related quality of life, or episodes of poor asthma control.
- Gastroesophageal reflux (GER) was present in 43% of a subgroup with esophageal pH studies, but lansoprazole showed no benefit in this subgroup.
- Children receiving lansoprazole reported more respiratory infections (RR, 1.3).
Conclusions:
- Lansoprazole is not effective in improving asthma symptoms or lung function in children with poorly controlled asthma and no overt GER symptoms.
- The use of lansoprazole in this population was associated with an increased risk of respiratory infections.
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