Eosinophilic Esophagitis: An Evidence-Based Approach to Therapy.

Eosinophilic Esophagitis: An Evidence-Based Approach to Therapy. J Investig Allergol Clin Immunol. 2016;26(1):8-18; quiz 2p following 18 Authors: González-Cervera J, Lucendo AJ Abstract In recent years, several randomized controlled trials and meta-analyses have evaluated the efficacy of the various therapeutic options available for treating patients with eosinophilic esophagitis, including dietary modifications, proton pump inhibitors, topical corticosteroids, and endoscopic esophageal dilation. Proton pump inhibitors are currently considered the first-line treatment for eosinophilic esophagitis, achieving histological remission and improvement of symptoms in 50.5% and 60.8% of patients, respectively. The efficacy of topical corticosteroids in eosinophilic esophagitis has been assessed in several trials. Meta-analyses summarizing results indicate that budesonide and fluticasone propionate are significantly superior to placebo, both in decreasing eosinophil densities in the esophageal mucosa and in relieving symptoms. However, owing to differences in drug delivery, viscous budesonide seems to be the best pharmacological therapy for eosinophilic esophagitis. Results for dietary modifications have been mixed depending on the type of diet prescribed. Thus, while exclusive amino acid-based elemental diets are the most effective in inducing histological remission of eosinophilic esophagitis (90.8%), their severe drawbacks limit their imp...
Source: Journal of Investigational Allergology and Clinical Immunology - Category: Allergy & Immunology Authors: Tags: J Investig Allergol Clin Immunol Source Type: research