Abstracts from Around the World

A link between gastroesophageal reflux (GER) and asthma has long been considered, and investigation for GER and/or empiric use of proton pump inhibitors for severe asthmatics with reflux symptoms is often undertaken. This double-blind multicenter trial randomized 412 patients with both inadequately controlled asthma despite inhaled corticosteroid use and minimal or no symptoms of GER to either 40 mg of esomeprazole twice daily or placebo. Patients were followed for 24 weeks with daily asthma diaries and spirometry performed once every 4 weeks. Ambulatory pH monitoring was performed to determine the presence or absence of GER. Reflux disease was self-reported in 19% of the placebo group and 10% of the treatment group. The primary outcome was the rate of episodes of poor asthma control based upon asthma diaries. No differences were detected in the number of episodes of poor asthma control between the two groups (2.3 and 2.5 per person year). There was also no treatment effect related to any outcome measurement. GER was identified by pH monitoring in 40% of these minimally symptomatic or asymptomatic patients, and its presence did not identify a subgroup that benefitted from proton pump inhibitor use.