Antireflux Treatment for Asthma

Harper, Philip C.

doi:10.1001/archinte.1987.00370010060015

Cited by 86 publications

(3 citation statements)

References 22 publications

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“…The characteristics of the included studies are described in table 1. Ten studies were excluded because the subjects did not have asthma,31-35 the trials were not randomised36 or not controlled,37 the interventions did not treat reflux,38 39 or the subjects did not have reflux 40…”

Section: Resultsmentioning

confidence: 99%

Medical treatment for reflux oesophagitis does not consistently improve asthma control: a systematic review

Coughlan

2001

Thorax

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Background-A systematic literature review was conducted to assess the eVect of treating reflux oesophagitis on asthma outcomes. Methods-Randomised controlled trials of reflux oesophagitis treatment in adults or children that reported asthma health outcomes were included and assessed in accordance with the standard Cochrane systematic review process. Patients were typically adults with asthma and concurrent symptomatic gastro-oesophageal reflux who received interventions that included pharmacological therapy, conservative management, and surgery. The following outcome measures were assessed: lung function, peak expiratory flow, asthma symptoms, asthma medications, and nocturnal asthma. Results-From 22 potentially relevant published and unpublished randomised controlled trials, 12 were included. Treatment duration ranged from 1 week to 6 months. Eight trials reported that treatment improved at least one asthma outcome, but these outcomes diVered between trials. Overall, treatment of reflux oesophagitis did not consistently improve forced expiratory volume in one second (FEV 1 ), peak expiratory flow rate, asthma symptoms, nocturnal asthma symptoms, or use of asthma medications in asthmatic subjects. Significant improvement in wheeze was reported in two studies. Conclusions-The published literature does not consistently support treatment of reflux oesophagitis as a means of controlling asthma. Further large randomised controlled trials in subjects with a demonstrated temporal relationship between gastro-oesophageal reflux and asthma are needed. These trials should be conducted over at least 6 months to allow adequate time to observe a treatment eVect.

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Section: Resultsmentioning

confidence: 99%

Medical treatment for reflux oesophagitis does not consistently improve asthma control: a systematic review

Coughlan

2001

Thorax

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“…Diagnostic approaches to identify reflux as an etiology for otherwise intractable asthma include (9) modified Bernstein test (with pulmonary function testing after saline and after acid infusions ; 59,104,105,109,[112][113][114], (b) endoscopy and/or esophageal histology 004,105,109 ,110,113) (c) EpHM with documentation of temporal relationship to wheezing episodes (59,108,114), (d) EpHM to quantify reflux (either in terms of total reflux time or sleep reflux time; 31,58,59,108,110 ,113,114), or (e) trial of empiric therapy for reflux.…”

Section: Reactive Airways Diseasementioning

confidence: 99%

“…EpHM may be used with pulmonary func-tion testing or with close observation for wheezing episodes if those episodes are intermittent (116) or simply to document abnormal quantity of reflux (117) or abnormal quantity of sleep reflux (58,62,118) to justify chronic therapy. A 2-month course of empiric treatment with acid suppression could also be considered (113) . Because of the ambiguity of the relationships between asthma, asthma medications, and reflux (52), the optimal approach to diagnostic evaluation has not yet been established and varies from case to case, dependent on clinicaljudgment.…”

Section: Reactive Airways Diseasementioning

confidence: 99%