Where Are We with Topical Steroid Use for Eosinophilic Esophagitis?

A head-to-head trial supports budesonide or fluticasone use, and an investigational budesonide formula shows promise.

Eosinophilic esophagitis (EOE) is commonly treated with a topical steroid — either a viscous budesonide preparation or swallowed fluticasone provided by pulmonary inhalers. Both approaches are off-label, expensive, sometimes not covered by insurance, and have no proven dose and duration of therapy. Some studies favor budesonide due to inadvertent inhalation of a substantial amount of the fluticasone dose despite careful patient education. Now, investigators report results of two randomized, controlled trials of budesonide for efficacy in EoE.

In one trial comprising 111 patients with newly diagnosed EoE randomized to a typical formulation of budesonide suspension or fluticasone, histologic remission rates were not significantly different (71…

Reviewing Author

Kenneth R. DeVault, MD

Disclosures

Consultant/Advisory BoardPhathom Pharmaceuticals

Grant/Research SupportIronwood Pharmaceuticals

Leadership Positions in Professional SocietiesAmerican College of Gastroenterology Education Universe (Co-Editor)

Kenneth R. DeVault, MD

Disclosures

Consultant/Advisory BoardPhathom Pharmaceuticals

Grant/Research SupportIronwood Pharmaceuticals

Leadership Positions in Professional SocietiesAmerican College of Gastroenterology Education Universe (Co-Editor)

Where Are We with Topical Steroid Use for Eosinophilic Esophagitis?

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Reviewing Author