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Lansoprazol para niños con asma mal controlada: un ensayo controlado aleatorizado
JAMA
|January 26, 2012
Resumen
El inhibidor de la bomba de protones lansoprazol no mejoró el control del asma en niños con asma mal controlada y sin síntomas evidentes de ERG. El medicamento no mejoró los síntomas de asma o la función pulmonar y aumentó las infecciones respiratorias.
Área de la Ciencia:
- Pulmonología Pediátrica.
- Gastroenterología y Gastroenterología.
Sus antecedentes:
- El reflujo gastroesofágico asintomático (GER) es común en niños con asma y puede contribuir a un mal control del asma.
- La eficacia de los inhibidores de la bomba de protones (IPP) para mejorar el control del asma en niños sin síntomas evidentes de ERGE no está bien establecida.
Objetivo del estudio:
- Evaluar la efectividad del lansoprazol en la mejora del control del asma en niños con asma mal controlada pero sin síntomas evidentes de ERG.
Principales métodos:
- Un ensayo aleatorizado, enmascarado y controlado con placebo (El estudio del reflujo ácido en niños con asma) que involucró a 306 niños con asma mal controlada que recibían corticosteroides inhalados.
- Los participantes recibieron lansoprazol o placebo durante 24 semanas.
- La puntuación del Cuestionario de Control del Asma (ACQ) fue el resultado primario; la función pulmonar y la calidad de vida fueron resultados secundarios.
Principales resultados:
- El lansoprazol no mejoró significativamente las puntuaciones del ACQ en comparación con el placebo (diferencia media de 0,2 unidades).
- No se observaron diferencias significativas en la función pulmonar, la calidad de vida relacionada con el asma o episodios de mal control del asma.
- El reflujo gastroesofágico (GER) estuvo presente en el 43% de un subgrupo con estudios de pH esofágico, pero el lansoprazol no mostró ningún beneficio en este subgrupo.
- Los niños que recibieron lansoprazol reportaron más infecciones respiratorias (RR, 1.3).
Conclusiones:
- El lansoprazol no es eficaz para mejorar los síntomas del asma o la función pulmonar en niños con asma mal controlada y sin síntomas evidentes de ERG.
- El uso de lansoprazol en esta población se asoció con un mayor riesgo de infecciones respiratorias.
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