Fernando D. Martinez, M.D., of the University of Arizona, Tucson, writes that the “overuse of PPIs in childhood asthma and in pediatrics in general is another example of a subtle but frequent phenomenon in clinical practice: therapeutic creep.”
“Clinicians extend the use of a treatment with real or suggestive therapeutic effects observed in a certain age group or in patients with a certain disease phenotype to other patients in whom the efficacy has never been demonstrated,” Dr. Martinez writes. “Therapeutic creep increases the risk of potential adverse effects without any added advantage for patients. It is also plausible to surmise that this phenomenon has substantially contributed to the marked increase in asthma drug costs, which are now the largest component of the direct costs for the disease.”
Dr. Martinez has served as a consultant to MedImmune and has presented at an Abbott-sponsored seminar.