Trial reportAnnals of the American Thoracic Society2015
Lansoprazole Is Associated with Worsening Asthma Control in Children with the CYP2C19 Poor Metabolizer Phenotype.
Trial report in Annals of the American Thoracic Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00604851, which is not on this map. Cited by 18 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Pharmacological and surgical interventions for the treatment of gastro-oesophageal reflux in adults and children with asthma.The Cochrane database of systematic reviews · 2021Pooled it
- Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.Journal of pediatric gastroenterology and nutrition · 2018Guideline
- Article
- Association betweenFrontiers in pharmacology · 2025Review
- Article
- Berberine Alleviates Gastroesophageal Reflux-Induced Airway Hyperresponsiveness in a Transient Receptor Potential A1-Dependent Manner.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- An approach to the management of children with problematic severe asthma.Acta bio-medica : Atenei Parmensis · 2020Review
- Gene-Based Dose Optimization in Children.Annual review of pharmacology and toxicology · 2020Review
- Article
- Impact of Gastroesophageal Reflux Disease on Mucosal Immunity and Atopic Disorders.Clinical reviews in allergy & immunology · 2019Review
- Does Obesity Increase Respiratory Tract Infections in Patients with Asthma?The journal of allergy and clinical immunology. In practice · 2019Observational
- Genotype tailored treatment of mild symptomatic acid reflux in children with uncontrolled asthma (GenARA): Rationale and methods.Contemporary clinical trials · 2019Article
- Proton pump inhibitors: from CYP2C19 pharmacogenetics to precision medicine.Expert opinion on drug metabolism & toxicology · 2018Review
- Clinical Pharmacogenetics of Cytochrome P450-Associated Drugs in Children.Journal of personalized medicine · 2017Article
- Improvement of Asthma and Gastroesophageal Reflux Disease With Oral Pulvis stomachicus cum Belladonna, a Combination of Matricaria recutita, Atropa belladonna, Bismuth, and Antimonite: A Pediatric Case Report.Global advances in health and medicine · 2016Article
- Reply: worsening asthma control in children taking lansoprazole: possible mechanisms.Annals of the American Thoracic Society · 2015Article
- Lansoprazole worsens asthma control in poor metabolizers: is nitric oxide involved?Annals of the American Thoracic Society · 2015Article
- From bench to bedside: a spotlight on pharmacogenomics at Nemours Children's Health.PharmacogenomicsArticle
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Authors and funding
8 authors at 6 institutions in 1 country.
Funding
Abstract
rationaleGastric acid blockade in children with asymptomatic acid reflux has not improved asthma control in published studies. There is substantial population variability regarding metabolism of and response to proton pump inhibitors based on metabolizer phenotype. How metabolizer phenotype affects asthma responses to acid blockage is not known.
objectivesTo determine how metabolizer phenotype based on genetic analysis of CYP2C19 affects asthma control among children treated with a proton pump inhibitor.
methodsAsthma control as measured by the Asthma Control Questionnaire (ACQ) and other questionnaires from a 6-month clinical trial of lansoprazole in children with asthma was analyzed for associations with surrogates of lansoprazole exposure (based on treatment assignment and metabolizer phenotype). Groups included placebo-treated children; lansoprazole-treated extensive metabolizers (EMs); and lansoprazole-treated poor metabolizers (PMs). Metabolizer phenotypes were based on CYP2C19 haplotypes. Carriers of the CYP2C19*2, *3, *8, *9, or *10 allele were PMs; carriers of two wild-type alleles were extensive metabolizers (EMs). MEASUREMENTS AND MAIN
resultsAsthma control through most of the treatment period was unaffected by lansoprazole exposure or metabolizer phenotype. At 6 months, PMs displayed significantly worsened asthma control compared with EMs (+0.16 vs. -0.13; P = 0.02) and placebo-treated children (+0.16 vs. -0.23; P < 0.01). Differences in asthma control were not associated with changes in gastroesophageal reflux symptoms. Recent upper respiratory infection worsened asthma control, and this upper respiratory infection effect may be more pronounced among lansoprazole-treated PMs.
conclusionsChildren with the PM phenotype developed worse asthma control after 6 months of lansoprazole treatment for poorly controlled asthma. Increased exposure to proton pump inhibitor may worsen asthma control by altering responses to respiratory infections. Clinical trial registered with www.clinicaltrials.gov (NCT00604851).
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