Study objectives: The prevalence of gastroesophageal
reflux disease (GERD) is higher in people with asthma than in control
populations. Predisposing factors for GERD development may include
asthma medications such as prednisone. The objective of this study was
to determine whether prednisone alters GERD parameters in people with
Design: Prospective, single-blinded,
placebo-controlled, crossover study.
University medical center clinic.
adults with stable, moderate persistent asthma with minimal esophageal
reflux symptoms (less than three times a week) who were not receiving
Intervention: Prednisone, 60 mg/d,
for 7 days.
Measurements and results: Asthma,
esophageal reflux symptoms, and spirometry were measured during
baseline, placebo, and prednisone phases, each 7 days in duration.
Dual-probe esophageal pH monitoring, esophageal and respiratory
manometrics (20 subjects), and basal and stimulated gastric acid
secretion (4 subjects) were measured after placebo and prednisone
phases. There were significant increases in esophageal acid contact
times at the distal and proximal pH probes during the prednisone phase.
Total percentage of time that pH was < 4.0 at the distal probe was
2.5 ± 0.4% for placebo compared with 5.9 ± 0.9% for prednisone
(p < 0.002). Total percentage of time that pH was < 4.0 at the
proximal probe was 0.3 ± 0.1% for placebo and
0.8 ± 0.2% for prednisone (p < 0.0007). There were no
significant changes in subject weight, spirometry, asthma or esophageal
reflux symptoms, manometrics, or basal or stimulated gastric acid
Conclusion: Prednisone, 60 mg/d for 7 days,
increased esophageal acid contact times in this small population of
people with stable asthma; however, the mechanism for this finding is