Asthma Clinical Trial
Official title:
The Study of Acid Reflux in Asthma
The purpose of this study is to determine if subjects with symptomatic asthma who are assigned to treatment with a proton pump inhibitor (PPI) drug such as Nexium have fewer asthma attacks than similar subjects assigned to placebo treatment.
BACKGROUND:
Gastroesophageal reflux (GERD) is frequent in asthmatics with poor asthma control, often
occurs without symptoms, and can induce bronchoconstriction. Poorly controlled asthmatics
are often treated for GERD with drugs that suppress gastric acid, but this treatment is
expensive and the benefit of such treatment is not established. Proton pump inhibitors are a
relatively new class of medications that provide highly effective treatment for GERD and
associated problems. This success has led many doctors to begin PPI treatment in their
asthma patients in an attempt to achieve better asthma control.
DESIGN NARRATIVE:
The randomized, placebo-controlled trial will enroll 400 asthmatics, ages 18 or older, who
have poor asthma control on inhaled steroids, defined on the basis of excessive
bronchodilator use, nocturnal awakenings, or frequent exacerbations. Participants will be
randomly assigned to treatment with either a proton pump inhibitor, esomeprazole (Nexium) 40
mg twice a day, or matching placebo. The presence, severity, and temporal relationship of
GERD to asthma symptoms will be documented with 24 hour ambulatory esophageal potential
Hydrogen (pH) probe monitoring, but participants will be enrolled irrespective of the
severity of GERD. The primary outcome measure is the proportion of participants who have
exacerbations of asthma within a 6-month period defined by asthma diaries and interviews.
Secondary outcome measures include asthma symptom and control scores, asthma-specific and
generic health-related quality of life, GERD symptoms, health care use, pulmonary function,
and airways reactivity. Pre-specified subgroup analyses will be conducted to determine if
there are clinical or demographic characteristics that predict benefit from treatment of
GERD in asthma.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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