Journal article
Recent insights on the use of topical steroids in eosinophilic esophagitis
Expert review of gastroenterology & hepatology, Vol.14(10), pp.953-963
10/02/2020
DOI: 10.1080/17474124.2020.1785869
PMID: 32567417
Abstract
Eosinophilic Esophagitis (EoE) is an immune-mediated, chronic inflammatory disorder of the esophagus. Topical steroids have been used in the management of EoE for over 15 years. However, there are no Food and Drug Administration (FDA) approved drug therapies for EoE.
This review discusses the current understanding of EoE and the role of topical steroids in the induction and maintenance of remission in patients with EoE. We performed a comprehensive review of the literature, summarized randomized control trials from 2006 to 2020, and provided a simplified management algorithm for EoE.
In patients with EoE, topical steroids are effective in inducing clinical and histologic remission. Formulations of topical steroids that maximize the exposure to esophageal mucosa have the highest efficacy. A majority of patients who achieve remission with topical steroids develop clinical and histologic relapse off therapy within a year. Current evidence suggests that maintenance therapy with long-term topical steroids decreases the risk of relapse and progression to fibrostenotic disease. While uncertainty over the dose and duration of maintenance topical steroids and their potential side effects exists, long-term maintenance therapy with topical steroids appears to be the way forward to improve long-term outcomes in patients with EoE.
Details
- Title: Subtitle
- Recent insights on the use of topical steroids in eosinophilic esophagitis
- Creators
- Aditi Reddy - University of Iowa Hospitals and ClinicsDivya Ashat - University of IowaArvind R. Murali - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Expert review of gastroenterology & hepatology, Vol.14(10), pp.953-963
- Publisher
- Taylor & Francis
- DOI
- 10.1080/17474124.2020.1785869
- PMID
- 32567417
- ISSN
- 1747-4124
- eISSN
- 1747-4132
- Language
- English
- Date published
- 10/02/2020
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984359795902771
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