In a trial performed in 2006 and in other performed in 2009, the use of esomeprazole in patients with asthma and gastroesophageal reflux has brought no improvement in asthma. Now, a new trial, sponsored by pharmaceutical industry, has randomized 961 patients with asthma and symptomatic GERD to treatment with esomeprazole (40 mg, once-twice a day) or placebo. After 26 weeks, the primary outcome of the trial (the measurement of the peak flow at awakening) has shown no differences between the active treatment and placebo: scores for asthma, the number of respiratory exacerbations, the percentage of days free from bronchospasm and the use of bronchodilators have been all similar. Differences have been recorded as to pump inhibitor only for the secondary outcomes, which had a poor clinical relevance (for example an improvement of FEV1 of about 100 ml).The use of a protonic pump inhibitor, even if widely used, does not improve asthma in patients affected also by gastroesophageal reflux; so, the use of a PPI in the subjects presenting only asthma seems completely unjustified.
