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Review
. 2020 Sep 28;26(36):5395-5407.
doi: 10.3748/wjg.v26.i36.5395.

Treatment of eosinophlic esophagitis with swallowed topical corticosteroids

Simon Nennstiel  1 , Christoph Schlag  2
Affiliations
Review

Treatment of eosinophlic esophagitis with swallowed topical corticosteroids

Simon Nennstiel et al. World J Gastroenterol. .

Abstract

Eosinophilic esophagitis (EoE) is an emerging chronic local immune-mediated disease of the esophagus. Beside proton pump inhibitors and food-restriction-diets swallowed topical corticosteroids (STC) can be offered as a first line therapy according to current guidelines. This review describes the background and practical management of STCs in EoE. So far, mainly asthma inhalers containing either budesonide or fluticasone have been administered to the esophagus by swallowing these medications "off label". Recently esophagus-targeted formulations of topical steroids have been developed showing clinicopathological response rates up to 85% - an orodispersible tablet of budesonide has been approved as the first "in label" medication for EoE in Europe in June 2018. Whereas it was shown that disease remission induction of EoE by STCs is highly effective, there is still a lack of data regarding long-term and maintenance therapy. However, current studies on STC maintenance therapy add some movement into the game.

Keywords: Budesonide; Budesonide oral suspension; Budesonide orodispersible tablet; Eosinophilic esophagitis; Esophagus-targeted formulations of topical steroids; Fluticasone; Swallowed topical corticosteroids.

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Conflict of interest statement

Conflict-of-interest statement: Nennstiel S received compensation for travel expenses by the Falk Foundation e.V. and Adare Pharmaceuticals, Inc.; Schlag C is a member of the advisory board of Adare Pharmaceuticals, EsoCap and Calypso and received speaker fees, travel and research funding from Dr. Falk Pharma GmbH and Falk Foundation e.V.

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