Asthma Clinical Trial
Official title:
A Double-blind Placebo Controlled Clinical Trial to Evaluate the Effects on Asthma Control of Rabeprazole Given Twice Daily in Subjects With Asthma.
The hypothesis for this study is that potent anti-secretory therapy with high dose PPI improves asthma control regardless of either asthma severity or the presence of GERD symptoms.
Many patients with GERD do not experience heartburn symptoms. Barium esophagram, endoscopy
and/or overnight esophageal pH monitoring are commonly relied upon to objectively establish
the diagnosis of GERD. In general, overnight esophageal pH monitoring is the most sensitive
and specific test available to confirm GERD. However, the literature exploring GERD as a
cause of chronic cough suggests that the currently accepted criteria for defining abnormal
overnight esophageal pH may not be adequately sensitive. It is therefore possible that
aggressive GERD therapy may improve asthma control in patients with "normal" overnight
esophageal pH probe results. To our knowledge, there are no published data addressing this
question.
Primary Objective The primary objective is to compare asthma control in asthmatic subjects
treated with high dose PPI with asthmatic subjects taking placebo PPI. The primary outcome
variables will be measurements of asthma symptoms and asthma quality of life.
Secondary Objectives Secondary objectives include evaluating the effect of this aggressive
anti-secretory therapy on lung function, asthma medication use (including both baseline and
rescue medication), and GERD symptoms. An additional secondary objective will be to evaluate
whether the presence or absence of GERD symptoms at baseline (prior to proton pump inhibitor
therapy) will independently associate with improvement in any of the other outcomes
measured.
Measurements will include: Juniper Asthma Control Questionnaire (visits 2 and 5), Juniper
Asthma Quality of Life Questionnaire (visits 2 - 5), GSAS gastroesophageal reflux instrument
(visit 2, visit 5), the occurrence of adverse events, change in FVC, FEF25-75%, MIF50 /
MEF50, peak expiratory flow rate, FEV1 reversibility, and the physical exam.
Additional measurements will include methacholine challenge and eosinophilia in induced
sputum specimens. Induced sputum will be offered to all patients, though it is anticipated
that only approximately 50% will agree to this procedure.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Prevention
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