Some study data have suggested certain subgroups, such as patients with episodes of nocturnal awakening and those with a body mass index greater than 30 kg/m
Lung function as measured on FEV1, peak flow, and tests of bronchial hyperresponsiveness also showed no effects of treatment, nor did patient-centered outcomes such as ACQ scores, even in patients with positive pH probe tests, Dr. Mastronarde said.
“In summary, asymptomatic GERD is common in patients with poorly controlled asthma, but PPI therapy with esomeprazole does not improve asthma control or lung function in patients with minimal or absent symptoms of GERD. … Ambulatory pH probe testing did not seem to identify any subgroups of patients who might benefit from PPI testing in terms of asthma control,” he said.
“The NIH guidelines suggest that we consider evaluation and treatment in patients with poorly controlled asthma on adequate controllers even without symptoms of GERD, but this study would suggest that PPI therapy has no effect on control and is not indicated,” Dr. Mastronarde noted. “Also, there doesn't seem to be any reason to do pH probe testing on poorly controlled asthmatics, because even if they are positive, it doesn't predict who will respond to PPI treatment.”