EoE Module 10 References-Dellon ES et al Clin Gastroenterol Hepatol Rapid recurrence of EoE activity after successful treatment

Dellon ES et al Clin Gastroenterol Hepatol Rapid recurrence of EoE activity after successful treatment

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The study examined eosinophilic esophagitis (EoE), a chronic disease that reoccurs when treatment stops, focusing on recurrence rates between oral viscous budesonide (OVB) and fluticasone from a multidose inhaler (MDI). Conducted as the observation phase of a randomized, double-blind trial, 58 subjects with an initial histologic response were included. Treatment was halted, and symptoms monitored over a year. If symptoms returned or at the year's end, participants underwent endoscopy and biopsy. <br /><br />Results showed that 57% of patients experienced symptom recurrence within the year, with a median recurrence time of 244 days and no significant difference between OVB and MDI groups. At recurrence, 78% had a histologic relapse, with significant symptom and endoscopic score increases. Additionally, only a minority showed any symptoms, highlighting unreliable symptom-detection of endoscopic and histologic activity.<br /><br />The findings suggest maintenance therapy should be recommended for EoE since most patients show endoscopic and histologic signs even when asymptomatic. The study reinforces the chronic nature of EoE and the necessity for sustained treatment. Despite the topical steroid used initially, rapid recurrence and the lack of reliable symptomatic indicators suggest patients with EoE require ongoing maintenance therapy to prevent disease activity resurgence. These insights are crucial for informing treatment strategies and patient care in EoE, emphasizing the disease's persistent progression and the importance of continuous management.

Keywords

eosinophilic esophagitis

chronic disease

recurrence rates

oral viscous budesonide

fluticasone

randomized double-blind trial

endoscopy

histologic relapse

maintenance therapy

treatment strategies