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Treatment with low-dose lansoprazole may reduce frequency of COPD exacerbations in older patients
  1. Laura Willis
  1. Correspondence to Dr L Willis, SpR, Northwick Park Hospital, Harrow, UK; willislk{at}doctors.org.uk

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Colds caused by respiratory viruses can trigger exacerbations of chronic obstructive pulmonary disease (COPD). This Japanese study investigated whether lansoprazole reduces the frequency of COPD exacerbations by mitigating the effects of respiratory viruses.

One hundred and three patients with COPD (mean age 75 years, 95% male), but without evidence of gastro-oesophageal disease, were randomised to receive lansoprazole 15 mg once daily or no treatment on top of their usual COPD medications. Patients were followed for 1 year during which time they recorded a daily score for symptoms of a common cold and attended hospital fortnightly. The authors used a healthcare utilisation definition for an exacerbation of COPD.

Direct comparison of the two groups using standard parametric tests revealed no difference in the frequency of common colds between the two groups, although multivariate analysis suggested that lansoprazole use may be associated with a lower risk of frequent colds (>3/year). There was a significant reduction in COPD exacerbations in the lansoprazole group (mean 0.34 exacerbations per year in the lansoprazole group vs 1.18 in the control group).

Apart from one patient in the treatment arm who withdrew due to diarrhoea, the authors give no information on adverse events in patients treated with lansoprazole. Reduction in viral infection by treatment with lansoprazole certainly warrants further study.

▸ Sasaki T, Nakayama K, Yasuda H, et al. A randomized, single blind study of lansoprazole for the prevention of exacerbations of chronic obstructive pulmonary disease in older patients. J Am Geriatr Soc 2009;57:1453–7.

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