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Combination therapy versus monotherapy for gastroesophageal reflux in children with difficult-to-treat bronchial asthma
Egyptian Journal of Chest Diseases and Tuberculosis [The]. 2014; 63 (1): 33-38
in English | IMEMR | ID: emr-154291
ABSTRACT
Gastroesophageal reflux [GER] is a common disorder in children with bronchial asthma. Difficult-to-treat asthma; It has been identified as a potential trigger, complication and even differential diagnosis for asthma. GERD; Our aim was to find out the efficacy of the combined use of both the proton pump inhibitor esomep-Proton pump inhibitors; razole and the antidopaminergic prokinetic domperidone versus the sole use of esomeprazole in Prokinetics improving asthma severity in children with difficult to treat asthma. Among 178 children with difficult-to-treat asthma, GER was assessed using upper GIT endoscopy. Those who had GER were randomly divided into 2 equal subgroups the first was treated with esomeprazole for 12 weeks while the other was treated with esomeprazole and domperidone for the same period [beside the usual treatment for asthma in both groups]. Childhood-asthma control test [C-ACT], forced expiratory volume in 1st second [FEVj] [% of predicted], peak expiratory flow [PEE] variability, induced sputum substance P [SP] and endoscopic reflux score [ERS] were recorded before and after the treatment. Gastro-esophageal reflux [GER] was observed in about 45% of children with difficult-to-treat asthma. The C-ACT, induced sputum SP, ERS and FEVj showed significant improvement while PEE variability showed no significant changes when comparing combination therapy subgroup [esomeprazole and domperidone] with esomeprazole only subgroup combination of domperidone and esomeprazole was more effective in improving the endoscopic reflux score, childhood-asthma control test [C-ACT] and FEVj [% of predicted] and significantly reduced the sputum SP than the use of esomeprazole only in children with difficult-to-treat asthma
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Index: IMEMR (Eastern Mediterranean) Main subject: Respiratory Function Tests / Asthma / Child / Treatment Outcome / Proton Pumps / Combined Modality Therapy / Endoscopy Limits: Female / Humans / Male Language: English Journal: Egypt. J. Chest Dis. Tuberc. Year: 2014

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Index: IMEMR (Eastern Mediterranean) Main subject: Respiratory Function Tests / Asthma / Child / Treatment Outcome / Proton Pumps / Combined Modality Therapy / Endoscopy Limits: Female / Humans / Male Language: English Journal: Egypt. J. Chest Dis. Tuberc. Year: 2014