Oral Viscous Budesonide Is Effective in Children With Eosinophilic Esophagitis in a Randomized, Placebo-Controlled Trial

Dohil, Ranjan; Newbury, Robert; Fox, Lyman; Bastian, John F.; Aceves, Seema S.

doi:10.1053/j.gastro.2010.05.001

Cited by 393 publications

(397 citation statements)

References 36 publications

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“…Patients who had evidence of a pathological amount of distal oesophageal acid exposure (>4% of the total study time) were treated with an oral proton pump inhibitor (PPI), esomeprazole 40 mg twice daily; and those with normal 24-h pH studies were treated with an oral budesonide suspension [two budesonide 0.5 mg ⁄ 2 mL ampules and one, 1 g packet of Splenda (sucralose) mixed together] twice daily for a total of 2 mg of budesonide per day. 11 Response to treatment was assessed by histology and symptoms as measured by the MDQ-30. All subjects underwent a standard 24-h transnasal catheter-based ambulatory oesophageal pH monitoring study.…”

Section: Methodsmentioning

confidence: 99%

Results of ambulatory pH monitoring do not reliably predict response to therapy in patients with eosinophilic oesophagitis

Francis

Foxx‐Orenstein

Arora

et al. 2011

Aliment Pharmacol Ther

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Section: Methodsmentioning

confidence: 99%

Results of ambulatory pH monitoring do not reliably predict response to therapy in patients with eosinophilic oesophagitis

Francis

Foxx‐Orenstein

Arora

et al. 2011

Aliment Pharmacol Ther

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“…While there is consensus among the members of scientific community and regulatory agencies that symptoms should be assessed by patients themselves [24,25], the extent of correlation between patient-reported outcomes and endoscopic and histologic findings has not yet been determined and needs to undergo further evaluation. [26][27][28][29] We addressed the potential issue of a referral bias by comparing the results of time-dependent stricture development in the group of 200 patients diagnosed by the senior author (AS) with the group of 460 externally diagnosed EoE patients. Although the assessment of endoscopic features at the time of EoE diagnosis was not standardized in this external cohort, we found, similarly to the results in the "core" cohort of 200 patients, that the prevalence of strictures at the time of EoE diagnosis significantly increased with ongoing duration of untreated disease.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Delay in Diagnosis of Eosinophilic Esophagitis Increases Risk for Stricture Formation in a Time-Dependent Manner

Schoepfer

Safroneeva

Bussmann³

et al. 2013

Gastroenterology

634

517

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“…Although there were no common criteria to define histological remission in the studies reviewed, a majority of the randomized controlled trial studies used more stringent values ranging from 0 to ≤5 eosinophils/hpf to define histological remission or resolution 22, 26, 66, 67, 68. Compared to dietary treatment studies (e.g.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of histological remission criteria in eosinophilic esophagitis

Eke

White

et al. 2018

JGH Open

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Elemental diets, dietary elimination, and steroid therapies are the most common therapies in the clinical trials for eosinophilic esophagitis (EoE). Histological findings (usually reported as eosinophils per microscopic high‐powered field [hpf]) remain the most common end‐point used to define response. Yet, the threshold for defining “response” and “remission” are ill‐defined among consensus guidelines and may vary from study to study. We conducted a systematic literature review of articles on eosinophilic esophagitis, published between January 2007 and November 2017, considering histological remission as the primary outcome. We abstracted treatment information and definitions of histological remission or response. A comparison of definitions of histological remission across and within institutions was performed. A total of 61 articles were included in this review, with approximately 60% of the studies published from centers in the United States. Histological definitions of remission of EoE ranged from 0 to ≤20 eosinophils/hpf. The most stringent criteria, ranging from 0 to ≤5 eosinophils/hpf, were commonly used in interventional trial studies that examined the effects of new treatments. We found remarkable variability in definitions between studies, treatment types, and regions. Age or epidemiological distribution of study subjects did not influence the criteria for histological remission. Clinical and histological improvements are important measures of the effects of treatment. Histological findings, the most objective measure of treatment, should provide an optimal method for comparing the effectiveness of various treatments. Yet, our findings suggest a lack of consistent remission criteria in published studies. Considering these inconsistencies, it is difficult to compare the effectiveness of various treatments.

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Oral Viscous Budesonide Is Effective in Children With Eosinophilic Esophagitis in a Randomized, Placebo-Controlled Trial

Cited by 393 publications

References 36 publications

Results of ambulatory pH monitoring do not reliably predict response to therapy in patients with eosinophilic oesophagitis

Results of ambulatory pH monitoring do not reliably predict response to therapy in patients with eosinophilic oesophagitis

Delay in Diagnosis of Eosinophilic Esophagitis Increases Risk for Stricture Formation in a Time-Dependent Manner

Systematic review of histological remission criteria in eosinophilic esophagitis

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