Effect of antisecretory therapy by omeprazole on night-time signs of bronchial asthma at its combination to GERD

Aim of investigation. To assess the effect of antisecretory therapy on night attacks of dyspnea in patients with bronchial asthma (BA) in combination to gastroesophageal reflux disease (GERD).

Stuff and methods. 162 BA patients – 59 men (36,4 %) and 103 women (63,6 %), mean age 68,1±10,2 year (32 to 92 years) were investigated. At 86 (53,1%) persons GERD has been diagnosed. In 41 (47,7%) of them night signs of asthma (attacks of difficulty in breathing, stuffiness in breasts, cough) were present. The first group (28 patients) with night signs received along with basic anti-inflammatory therapy for BA antisecretory therapy by proton pump inhibitor ultop (omeprazole, «KRKA», Slovenia) 40 mg per day for 28 days. The second group (13 patients) took no antisecretory therapy and only symptomatic intake of antacids on-demand was allowed. Evaluation of treatment effect on GERD and BA signs was done on 7, 14, 21 and 28 day of the study. Severity of GERD was determined according to five-point Likert’s scale. Effect on the course of BA was estimated by dynamics of daytime and night signs, requirement in bronchodilators per day, change of FEV1 and VC values.

Results. In the first group decrease of main signs of GERD at the 7th to day of investigation was revealed in 19 (67,8%) patients, and at 14, 21 and 28th days, respectively in 22 (78,5 %), 25 (89,3%) and 26 (92,9%) patients. Four-week antisecretory therapy resulted in relief of clinical symptoms of GERD (first of all — heartburn) in over 90% of patients. Number of daytime attacks of dyspnea has decreased from 3,22±1,29 up to 2,33±0,42, night attacks – from 0,80±0,17 to 0,42±0,15, and average requirement in bronchodilators – from 6,83±2,39 per day up to 5,31±2,35, differences were statistically significant. The most pronounced effect has been obtained for night attacks of difficulty in breathing (decrease of their number by 51,9%), smaller effect was rendered on amount of day attacks – decrease by 24,1%, consumption of bronchodilators was reduced by 20,7 %. Increase in mean FEV1 from 64,08±19,11 to 65,88±21,27%, VC – with 75,0±20,27 up to 79,79±20,23% was observed. Changes of similar scores in the second group of the patients taking antacids on demand, were statistically insignificant.

Conclusion. Results of original study prove the necessity to include antisecretory agents to standart mode of treatment for patients with bronchial asthma, combined to GERD.

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