Symptomatic GORD in difficult asthma is associated with worse asthma control and related comorbidities: Findings from WATCH

Abstract

Background: Difficult asthma is associated with increased prevalence of gastro-oesophageal reflux disease (GORD). However, it is unclear how controlling comorbid GORD impacts difficult asthma. Aim: To evaluate the impact of effectively controlling GORD symptoms in difficult asthmatics in the Wessex AsThma Cohort of difficult asthma (WATCH) Southampton UK. Methods: A retrospective analysis was undertaken to compare the reported symptoms of GORD in 311 adult asthmatics on treatment for GORD. We compared patients with ongoing GORD symptoms against those with no symptoms using Chi square (categorical data) and Mann-Whitney U tests (continuous data). Results: 208 (67%) difficult asthmatics had GORD, of whom 175 were receiving treatment for GORD. Prevalence of symptomatic GORD in those having treatment did not differ by sex, but was associated with higher BMI, worse asthma control and symptoms of depression, rhinitis and cough. Conclusion: Inadequately controlled GORD in difficult asthma is associated with increased symptoms of asthma, and related comorbidities. This highlights multiple potential benefits of optimising GORD treatment in difficult asthmatics.