Asthma and gastro-oesophageal reflux: can the response to anti-reflux therapy be predicted?

The aim of the study was to investigate which features predict favourable r esponse to omeprazole therapy in asthmatics with gastro-oesophageal reflux (GER). The study population consisted of 52 outpatient asthmatics with GER who had completed an intervention where they were randomized to receive omeprazole 40 mg once a day or placebo for 8 weeks. After a 2-week washout period the patients were crossed over. Asthma symptoms were found to be relieved grea ter than or equal to 20% in 18 (35%) patients who were thus regarded as res ponders. A logistic regression analysis was performed in order to identify which features separate the responders From the non-responders. More responders were found among the patients whose body mass index (BMI) w as higher (P = 0(.)02) or whose distal esophageal reflux was more severe [t otal time (%) pH < 4 (P = 0(.)01) or time (%) pH ( 4 in upright position (P = 0(.)04)]. Adding other predictors to the total time (%) pH < 4. which wa s the most significant predictor for response in multi-variate analysis, di d not further increase the prediction for favourable outcome. It is concluded that savers distal oesophageal reflux and obesity predict a melioration in asthma symptoms after X-week omeprazole treatment in asthmat ics with GER. Adding more than one predictor does not seem to further incre ase prediction for favourable asthma response.