- Title
- Swallowed fluticasone improves histologic but not symptomatic response of adults with eosinophilic esophagitis
- Creator
- Alexander, Jeffrey A.; Jung, Kee Wook; Talley, Nicholas J.; Arora, Amindra S.; Enders, Felicity; Katzka, David A.; Kephardt, Gail M.; Kita, Hirohito; Kryzer, Lori A.; Romero, Yvonne; Smyrk, Thomas C.
- Relation
- Clinical Gastroenterology and Hepatology Vol. 10, Issue 7, p. 742-749
- Publisher Link
- http://dx.doi.org/10.1016/j.cgh.2012.03.018
- Publisher
- American Gastroenterological Association
- Resource Type
- journal article
- Date
- 2012
- Description
- We evaluated the effect of aerosolized fluticasone therapy on symptomatic dysphagia and histologic eosinophilia in adults with eosinophilic esophagitis (EoE). We performed a double-blind, randomized, placebo-controlled trial of fluticasone in 42 adult patients with a new diagnosis of EoE (30 men; mean age, 37.5 y). Participants were assigned randomly to groups that swallowed 880 μg of aerosolized fluticasone twice daily (n = 21), or took a placebo inhaler twice daily (n = 15) for 6 weeks. End points of the study were symptomatic and histologic response. A complete histologic response (>90% decrease in mean eosinophil count) was observed in 11 of 15 subjects who received 6 weeks of fluticasone (62%), compared with none of the 15 subjects who received placebo (P < .001), based on intention-to-treat analysis; histologic responses were observed in 68% of subjects who received fluticasone (13 of 19) compared with none of those who received placebo (0 of 15) by per-protocol analysis (P < .001). Intracellular staining for eosinophil-derived neurotoxin was reduced in 81% of subjects who received fluticasone (13 of 16) compared with 8% who received placebo (1 of 13) (P < .001). Dysphagia was reduced in 57% of subjects who received fluticasone (12 of 21) compared with 33% who received placebo (7 of 21) (P = .22) by intention-to-treat analysis; dysphagia was reduced in 63% of patients who received fluticasone (12 of 19) and 47% of those who received placebo (7 of 15) (P = .49) based on per-protocol analysis. Esophageal candidiasis developed in 26% of subjects who received fluticasone (5 of 19), but in none of the subjects in the placebo group (P = .05). Aerosolized, swallowed fluticasone leads to a histologic but not a symptomatic response in adults with EoE.
- Subject
- esophagus; EDN; steroid treatment; dysphagic
- Identifier
- http://hdl.handle.net/1959.13/939322
- Identifier
- uon:12781
- Identifier
- ISSN:1542-3565
- Language
- eng
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