Effect of Esomeprazole 40 mg Once or Twice Daily on Asthma: A Randomized, Placebo-controlled Study Toni O. Kiljander, Ola Junghard, Ola Beckman and Tore Lind

AJRCCM Vol 181. pp. 1042-1048, (2010) doi: 10.1164/rccm.200910-1537OC

Large study with a double-blind placebo control arm evaluated the effect of Nexium used one and two times per day. While there was no difference between once or twice daily Nexium, but treatments improved FEV1 slightly (about .1L) and Asthma Quality of Life type questions improved.

The authors stated that "esomeprazole may improve pulmonary function and asthma-related quality of life. However, the improvements were minor and of small clinical significance".

What needs to be emphasized is that the use of PPIs, like Nexium, are great in Asthmatics with reflux disease, but the routine use PPIs in asthma patients who may not have reflux is really not supported by medical research. Since someone who has BOTH asthma and reflux diseases only improve slightly, the chances are even smaller that pulmonary function or symptoms will improve in someone with only Asthma. Thus, there remains no compelling rationale to use these type of medicines (PPIs) routinely in the care of asthma.