PPIs do not reduce COPD exacerbations

Thursday, 17 Mar 2016

Reflux is a well known trigger for exacerbations in people with COPD yet treatment with proton pump inhibitors do not appear to reduce the risk, research shows.

Writing in Respirology the researchers from Switzerland and The Netherlands noted that previous studies had found GERD was a trigger for acute exacerbations.

It was therefore reasonable to suggest that treatment with PPIs could mitigate this risk, they said.

However in an analysis of 638 COPD patients from the observational PROMISE-COPD patients who were receiving treatment for reflux remained at high risk of both frequent and severe exacerbations.

These findings were independent of adjusted Charlson score, predicted FEV1%, BODE index, Modified Medical Research Council scores and other medication for comorbidities.

Treating GERD with acid reducing medication can help control symptoms, however GERD was also associated with a mechanical breach of the anti-reflux barrier, the researchers noted.

“As long as patients remain obstructive, they will have reflux, and that is why anti-GERD therapy may not be the final solution to reflux in airway obstruction,” they wrote.

They added that their conclusions needed to be confirmed in a randomized placebo controlled trial.

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