PURPOSE: To investigate whether proton pump inhibitor (PPI) reduces the frequencies of the common cold and subsequent exacerbation in patients with chronic obstructive pulmonary disease (COPD).
METHODS: One hundred patients with COPD were enrolled into this prospective randomized controlled trial. They were all ex-smokers and had received usual therapies for COPD, including bronchodilators. None of them showed any symptoms of gasroesophageal reflux disease (GERD) or gastritis. The patients were randomly assigned to the usual therapies for COPD (control group; n=50), or to the usual therapies plus proton pump inhibitor (PPI group; n=50). Patients then were observed for 12 months. During the period, the frequencies of catching common colds and COPD exacerbations were assessed.
RESULTS: The number of acute exacerbations per person in a year in the PPI group was significantly lower than that in the control group (0.34±0.10 vs 1.18±0.20, p=0.0003). According to the logistic regression method, the relative risk of having one or more exacerbations in the PPI group compared with that in the control group was 0.23 (95% confidence interval [CI]= 0.08-0.62; p=0.004). On the other hand, there was some tendency but no significant difference between the numbers of common colds per person in a year in the PPI group and the control group (1.22±0.29 vs 2.04±0.43; p=0.12). However, the logistic regression analysis showed that the relative risk of catching common colds frequently (≥ 3 times/year) in the PPI group compared with that in the control group was 0.28 (95% CI= 0.08 to 0.99; p=0.048).
CONCLUSIONS: Adding PPI on the usual therapies has beneficial effects on the prevention of exacerbations in COPD patients.
CLINICAL IMPLICATIONS: Adding lansoprazole to conventional therapy is a new strategy for the prevention of COPD exacerbations.
DISCLOSURE: The following authors have nothing to disclose: Sasaki Takahiko, Katsutoshi Nakayama, Hiroyasu Yasuda, Toshihiro Nukiwa, Mutsuo Yamaya
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