Eosinophilic Oesophagitis in Children: Disease Modulation by Topical Steroids

Eosinophilic Oesophagitis in Children: Disease Modulation by Topical Steroids Purpose of review Eosinophilic oesophagitis (EoE) is a chronic inflammatory disease, and effective treatment for paediatric EoE is still evolving. There is no consensual standard therapy for adults or children,asevolvingconceptsstill need to be properly validated and there has been continuous update from published trials. This paper summarizes the current knowledge about inflammatory background and corticosteroid therapy in paediatric eosinophilic oesophagitis. Recent findings There are some effective therapies in EoE treatment, and current- ly, the use of PPI may be considered as the first-line treatment, as a sub-group of EoE patients can be responsive to them. However, a considerable proportion of patients will not respond both clinically and histologically or will recur. Various dietary options and topical steroids are valid alternatives. Basic research has shown that corticosteroids downregulate inflammation and prevent remodelling, reducing the long-term complication rate, mainly related to stenosis. Corticosteroids are effective and safe especially if delivered in a viscous solution (budesonide, fluticasone). New formulations may be available soon thereby spar- ing the need for home-made manipulations. Clinical remission and the possibility to maintain treatment for long periods without serious side-effects make this option attractive in paediatric patients that have the prospect of long-term disease. Summary Corticosteroids are http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Treatment Options in Allergy Springer Journals

Eosinophilic Oesophagitis in Children: Disease Modulation by Topical Steroids

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Publisher
Springer International Publishing
Copyright
Copyright © 2017 by Springer International Publishing AG
Subject
Medicine & Public Health; Allergology; General Practice / Family Medicine
eISSN
2196-3053
D.O.I.
10.1007/s40521-017-0142-4
Publisher site
See Article on Publisher Site

Abstract

Purpose of review Eosinophilic oesophagitis (EoE) is a chronic inflammatory disease, and effective treatment for paediatric EoE is still evolving. There is no consensual standard therapy for adults or children,asevolvingconceptsstill need to be properly validated and there has been continuous update from published trials. This paper summarizes the current knowledge about inflammatory background and corticosteroid therapy in paediatric eosinophilic oesophagitis. Recent findings There are some effective therapies in EoE treatment, and current- ly, the use of PPI may be considered as the first-line treatment, as a sub-group of EoE patients can be responsive to them. However, a considerable proportion of patients will not respond both clinically and histologically or will recur. Various dietary options and topical steroids are valid alternatives. Basic research has shown that corticosteroids downregulate inflammation and prevent remodelling, reducing the long-term complication rate, mainly related to stenosis. Corticosteroids are effective and safe especially if delivered in a viscous solution (budesonide, fluticasone). New formulations may be available soon thereby spar- ing the need for home-made manipulations. Clinical remission and the possibility to maintain treatment for long periods without serious side-effects make this option attractive in paediatric patients that have the prospect of long-term disease. Summary Corticosteroids are

Journal

Current Treatment Options in AllergySpringer Journals

Published: Aug 11, 2017

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