Topical Corticosteroid Treatment of Dysphagia Due to Eosinophilic Esophagitis in Adults

Eosinophilic Esophagitis–More than Two Decades of Progress

“…In a 2006 RCT of 21 EoE pediatric patients that were treated with fluticasone, 50% achieved histologic remission defined as a peak eosinophil count of < 1 eosinophil / HPF, versus only 9% of patients receiving placebo (P=0 .047) [54]. Similar findings of symptomatic improvement were seen in adult patients receiving fluticasone [55]. A study by Remedios et al treated EoE patients with fluticasone, including a subset of patients with concomitant GERD.…”

Emerging concepts of dietary therapy for pediatric and adult eosinophilic esophagitis

“…Spergel et al [16] reported an 81% success rate with a modified SFED and identified causative foods in 34% of patients (Table 1). Multiple studies have reported a response rate to swallowed steroids in both adult and pediatric EoE populations with response rates ranging from 50 to 87% [17][18][19][20], similar to the response rate of the empiric elimination diets reported above (including modified www.expert-reviews.com Editorial SFED). In addition, there appears to be potential to identify causative foods in 35-40% of patients.…”

Eosinophilic Esophagitis: A Comprehensive Review

“…Prolonged fluticasone treatment in one study led to a non-significant reduction in sub- epithelial collagen deposition and significant reduction in CCL18 gene expression, a pro-fibrotic cytokine [93]. More convincingly, a randomized, double blind, placebo controlled trial by Strauman et al, of budesonide over 15 days not only showed significant reduction in eosinophils and alpha tumor necrosis factor, but also significant reduction in lamina propria fibrosis and EGF-beta 1 expression [94].…”