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Audrey Abella, 05 Oct 2020
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Do GERD and asthma represent one-two punch for children?

13 Aug 2020

Children with gastro-oesophageal reflux disease (GERD) are at heightened risk of developing asthma, and those with asthma are prone to develop GERD, according to a study, which suggests that the two conditions have a bidirectional relationship.

The study used data from the Korean Health Insurance Review and Assessment Service-National Sample Cohort and included two patient cohorts of children aged <15 years: 86,096 asthmatic patients and 86,096 matched controls (cohort 1), and 532 GERD patients and 1,064 matched controls (cohort 2).

In cohort 1, more patients in the asthma than in the control group developed GERD (0.7 percent vs 0.5 percent; p<0.001). The mean time to GERD diagnosis was 76.9 months in the asthma group and 77.4 months in the control 1 group.

Cox proportional hazards regression showed that in the presence of asthma, the risk of incident GERD increased by 36 percent (hazard ratio [HR], 1.36, 95 percent confidence interval [CI], 1.20–1.54; p<0.001). Results were consistent in subgroups defined by age and sex.

Likewise, in cohort 2, significantly more children with GERD developed asthma compared with controls (15.0 percent vs 10.0 percent; p<0.001). The mean time to asthma diagnosis was 28.3 months in the GERD group and 22.3 months in the control group.

GERD was associated with a 62-percent increased risk of developing asthma (HR, 1.62, 95 percent CI, 1.21–2.18; p=0.001). The risk increase was observed in all GERD subgroups except for children aged 5–9 years and boys.

Researchers cited evidence from prior studies suggesting that GERD could increase the risk of asthma via reflux-induced airway damage and inflammation, whereas asthma might lead to subsequent GERD through systemic inflammation or the vagal reflex. [Respir Med 2018;143:42-47; Respir Med 2006;100:307-315; Am J Med 2001;111(Suppl 8A):13S-17SS]

Given that the study could not count subclinical cases/underdiagnosed/and untreated asthma or GERD and did not include data on asthma types and possible comorbidities, the researchers urged consideration of the present limitations in future investigations on the causality of the relationship between asthma and GERD.

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Most Read Articles
Pearl Toh, 21 Sep 2020
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
Roshini Claire Anthony, 22 Sep 2020

Treatment with the DPP 1* inhibitor brensocatib prolonged time to exacerbation and reduced exacerbation rates in patients with non-cystic fibrosis bronchiectasis, according to the phase II WILLOW** study presented at ERS 2020.

Audrey Abella, 22 Sep 2020
The first-in-class oral tyrosine kinase inhibitor (TKI) masitinib demonstrated a positive benefit-risk profile over a sustained period in patients with severe persistent asthma regardless of baseline eosinophil level, with the greatest benefit seen among those with the highest oral corticosteroid (OCS) dependency, according to data presented at ERS 2020.
Audrey Abella, 05 Oct 2020
Regular, low-dose, oral sustained-release morphine improved the health status of patients with moderate-to-very-severe chronic breathlessness due to chronic obstructive pulmonary disease (COPD), the MORDYC* trial has shown, validating its palliative role for chronic breathlessness.