Jeannette Y. Wick, RPh, MBA, FASCP
The common practice of prescribing proton pump inhibitors to children with asthma appears to be without basis, according to the results of a study.
Children with asthma often show gastroesophageal reflux (GER) symptoms. Some researchers believe that a failure to treat GER may hinder control of asthma in children, even if patients are being treated with inhaled corticosteroids. In recent years, doctors have routinely prescribed proton pump inhibitors (PPIs) for inadequately controlled asthma, whether GER symptoms are present or not, leading to a dramatic increase in pediatric PPI prescriptions between 2000 and 2005.
A team of researchers from the American Lung Association Asthma Clinical Research Centers published a study investigating whether PPIs help control asthma
in the January 25, 2012, edition of the Journal of the American Medical Association
. The researchers selected 306 children between the ages of 6 and 17, all of whom had poorly controlled asthma despite taking inhaled corticosteroids and were asymptomatic for GER. The participants were randomly assigned to 2 groups: 149 took the PPI lansoprazole, and 157 took a placebo. The researchers found that the lansoprazole group experienced no improvement as measured by their Asthma Control Questionnaire score, forced expiratory volume, asthma-related quality of life, or rate of episodes of poor asthma control.
Additionally, the researchers found that taking lansoprazole may actually harm children with asthma. The children who took lansoprazole self-reported more respiratory symptom episodes, including sore throats, bronchitis, and upper respiratory tract infections. Overall, those in the lansoprazole group had a 30% increased risk of reporting a respiratory infection. In addition, the researchers note that a different clinical trial found that infants given lansoprazole contracted more lower respiratory tract infections. The researchers conclude that further studies should be undertaken to investigate the risks associated with long-term PPI use by children.
Ms. Wick is a visiting professor at the University of Connecticut School of Pharmacy and a freelance writer from Virginia.