The Efficacy of Proton Pump Inhibitors for the Treatment of Asthma in Adults

Chan, Walter W.; Chiou, Eric; Obstein, Keith L.; Tignor, April S.; Whitlock, Tom L.

doi:10.1001/archinternmed.2011.116

Cited by 95 publications

(72 citation statements)

References 69 publications

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“…However, a meta-analysis of 11 randomized controlled trials concluded that PPI therapy in adults with asthma results in a statistically signifi cant but overall only a small improvement in peak expiratory fl ow rate, that is unlikely to be of meaningful clinical signifi cance. Th us, there is insuffi cient evidence to recommend PPIs for routine asthma treatment when other GERD symptoms are absent ( 139 ). Improvement in peak expiratory fl ow was greater, though still modest, in the eight studies that required evidence of GERD (by symptoms, endoscopy, or refl ux monitoring) compared with the three studies that did not require evidence of GERD.…”

Section: Gerd Refractory To Treatment With Ppismentioning

confidence: 99%

Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease

Katz¹,

Gerson²,

Vela³

2013

American Journal of Gastroenterology

1,483

1,386

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Section: Gerd Refractory To Treatment With Ppismentioning

confidence: 99%

Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease

Katz¹,

Gerson²,

Vela³

2013

American Journal of Gastroenterology

1,483

1,386

View full text Add to dashboard Cite

“…In terms of their long-term use, published studies have reported PPI use for up to 11 years in small numbers of children. 16 The Food and Drug Administration has approved a number of PPIs for use in pediatric patients in recent years, including omeprazole, lansoprazole, and esomeprazole for people 1 year and older and rabeprazole for people 12 years and older. Nonetheless, the new guidelines strike a note of caution when discussing the dramatic increase in past years in the number of PPI prescriptions written for pediatric patients, particularly infants, who may be at increased risk of lower respiratory tract infections.…”

Section: Ppismentioning

confidence: 99%

“…10,11 Although older studies from the 1990s suggested that GERD may aggravate asthma, recent publications have suggested that the impact of GERD on asthma control is considerably less than previously thought. 10,[12][13][14][15][16][17][18] Other extraesophageal manifestations include dental erosions, and proposed associations include pharyngitis, sinusitis, and recurrent otitis media. Patients can be described clinically by their symptoms or by the endoscopic description of their esophageal mucosa.…”

Section: Introductionmentioning

confidence: 99%

Gastroesophageal Reflux: Management Guidance for the Pediatrician

Lightdale¹,

Gremse²,

2013

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Recent comprehensive guidelines developed by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition define the common entities of gastroesophageal reflux (GER) as the physiologic passage of gastric contents into the esophagus and gastroesophageal reflux disease (GERD) as reflux associated with troublesome symptoms or complications. The ability to distinguish between GER and GERD is increasingly important to implement best practices in the management of acid reflux in patients across all pediatric age groups, as children with GERD may benefit from further evaluation and treatment, whereas conservative recommendations are the only indicated therapy in those with uncomplicated physiologic reflux. This clinical report endorses the rigorously developed, well-referenced North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines and likewise emphasizes important concepts for the general pediatrician. A key issue is distinguishing between clinical manifestations of GER and GERD in term infants, children, and adolescents to identify patients who can be managed with conservative treatment by the pediatrician and to refer patients who require consultation with the gastroenterologist. Accordingly, the evidence basis presented by the guidelines for diagnostic approaches as well as treatments is discussed. Lifestyle changes are emphasized as first-line therapy in both GER and GERD, whereas medications are explicitly indicated only for patients with GERD. Surgical therapies are reserved for children with intractable symptoms or who are at risk for life-threatening complications of GERD. Recent black box warnings from the US Food and Drug Administration are discussed, and caution is underlined when using promoters of gastric emptying and motility. Finally, attention is paid to increasing evidence of inappropriate prescriptions for proton pump inhibitors in the pediatric population.

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“…Though the cause-effect relationship between asthma and acid reflux isn't clear why, acid reflux can worsen asthma and asthma can worsen acid reflux (6). However, Chan WW and co-workers, 2011 claimed that gastroesophageal reflux disease occurs frequently among patients with asthma, despite that the therapy with proton pump inhibitors to improve asthma control remains controversial (13). Moreover, two proposed mechanisms involved in the pathogenesis of GERD associated cough:…”

Section: Discussion:-mentioning

confidence: 99%