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Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Mar 21, 2007; 13(11): 1706-1710
Published online Mar 21, 2007. doi: 10.3748/wjg.v13.i11.1706
Effect of omeprazole and domperidone on adult asthmatics with gastroesophageal reflux
Bhavneesh Sharma, Manisha Sharma, Mradul Kumar Daga, Gopal Krishan Sachdev, Elliott Bondi
Bhavneesh Sharma, Manisha Sharma, Elliott Bondi, Brookdale University Hospital and Medical Center, Division of Pulmonary and Critical Care Medicine, State University of New York, Brooklyn, New York 11212, United States
Mradul Kumar Daga, Gopal Krishan Sachdev, University of Delhi, Maulana Azad Medical College, Divisions of Pulmonary Medicine and Gastroenterology, New Delhi 110002, India
Author contributions: All authors contributed equally to the work.
Supported by a research grant from the University of Delhi, No. 52301/01 and Glaxo Smithkline Pharmaceuticals Limited and Dr. Reddy’s Laboratories Ltd, No. 9834512
Correspondence to: Bhavneesh Sharma, MD, Department of Internal Medicine, Brookdale University Hospital and Medical Center, State University of New York, Brooklyn, New York 11212, United States. bhavneesh@hotmail.com
Telephone: +1-718-2405000 Fax: +1-718-2406344
Received: January 17, 2007
Revised: January 25, 2006
Accepted: January 31, 2007
Published online: March 21, 2007
Abstract

AIM: To study the effect of combined omeprazole (Ome) and domperidone (Dom) therapy on asthma symptoms and pulmonary function in asthmatics with gastroesophageal reflux.

METHODS: We selected 198 asthmatics with gastroesophageal reflux diagnosed by 24-h esophageal pH monitoring to receive Ome 20 mg twice daily and Dom 10 mg three times daily or placebo for 16 wk (1:1 double-blind randomization). Spirometry was done at baseline and after 16 wk of treatment. The primary outcome measures were: mean daily daytime and nighttime asthma symptom scores. Mean daily reflux symptom scores, albuterol use as rescue medication (number of puffs), daytime and nighttime peak expiratory flow rate (PEFR), postbronchodilator forced expiratory volume in 1 second (FEV1) and postbronchodilator forced vital capacity (FVC) were secondary outcome measures.

RESULTS: Comparison of mean change from baseline between antireflux therapy and placebo groups revealed significant reduction in daytime asthma symptom score (17.4% vs 8.9%), nighttime asthma symptom score (19.6% vs 5.4%), reflux symptom score (8.7% vs 1.6%) and rescue medication use (23.2% vs 3.1%) after antireflux therapy compared to mean change in placebo group (P < 0.001). There was significant improvement in morning PEFR (7.9% vs 0.2%), evening PEFR (9.8% vs 0.5%), FEV1 (11.1% vs 3.78%) and FVC (9.3% vs 1.52%) in the antireflux therapy group compared to placebo on comparing the mean change from baseline after 16 wk (P < 0.01).

CONCLUSION: Combined therapy with Ome and Dom in adult asthmatics with gastroesophageal reflux may be beneficial by reducing asthma symptoms, rescuing medication use, and improving pulmonary function.

Keywords: Asthma, Reflux, Gastroesophageal reflux disease, Antireflux therapy, Prokinetic, Omeprazole