Study Shows Prescription Heartburn Medication Does Not Control Asthma Symptoms as Thought

For nearly 20 years, it was believed that severe asthma symptoms such as coughing, wheezing and breathlessness were triggered in part by acid reflux.

April 9, 2009

• American Lung Association study reported in New England Journal of Medicine

• UAB Lung Health Center part of trial

• Call to change prescription guidelines

BIRMINGHAM, Ala. - For nearly 20 years, it was believed that severe asthma symptoms such as coughing, wheezing and breathlessness were triggered in part by acid reflux. A new study conducted by the American Lung Association's Asthma Clinical Research Centers (ACRC), which includes the UAB (University of Alabama at Birmingham) Lung Health Center, finds the long-standing practice of prescribing heartburn medication to be ineffective and unnecessarily expensive for asthma patients who do not exhibit symptoms associated with acid reflux such as heartburn or stomach pain.

Patients participating in the ACRC study were randomly given either 80 milligrams of esomeprazole (Nexium) or placebo. Patients in both groups had similar numbers of poor asthma control episodes, and there were no differences in their lung function or other asthma symptoms. These results show that esomeprazole was no more effective than placebo for the treatment of asthma.

The results of this study, which were published today in the New England Journal of Medicine, are considered to be the most comprehensive evaluation to date of the efficacy of prescription heartburn medication to control respiratory flare-ups in asthmatics whose symptoms have not been well controlled by other therapies.

"Each year, people with asthma are spending as much as $10 million dollars on prescription heartburn medication believing it will help control attacks of wheezing, coughing and breathlessness," said Norman H. Edelman, M.D., American Lung Association Chief Medical Officer. "Now we know with confidence that silent acid reflux does not play a significant role in poor asthma control. Talk with your doctor before discontinuing any medication, as each patient's specific needs will vary."

For asthma patients with symptoms of gastric reflux such as heartburn that occurs at least twice weekly, the American Lung Association recommends prescription heartburn medication be taken to control heartburn and not asthma symptoms.

The drug's manufacturer, AstraZeneca, provided the medication for the study that was funded by the American Lung Association and the National Heart, Lung and Blood Institute, a component of the National Institutes of Health. AstraZeneca is the national sponsor of the American Lung Association's Breathe Well, Live Well: An Asthma Management Program for Adults. This partnership has helped expand the program into diverse communities across the nation.

The ACRC Network is an American Lung Association-sponsored research program that conducts large scale clinical trials with the mission of advancing the care and treatment of people with asthma. The UAB Lung Health Center is part of the network. The leaders of the study at UAB were William Bailey, M.D., professor of medicine in the division of pulmonary, allergy and critical care medicine, and Lynn Gerald, Ph.D., formerly associate professor in the division. The network, with a central data coordinating center and 20 clinical centers located across the country, is the largest of its kind. For more information on the American Lung Association, call 1-800-LUNG-USA (1-800-586-4872) or visit www.lungusa.org.