e-Article
Swallowed topical corticosteroids for eosinophilic esophagitis: Utilization and real‐world efficacy from the EoE CONNECT registry
Document Type
Report
Author
Laserna‐Mendieta, Emilio J.; Navarro, Pilar; Casabona‐Francés, Sergio; Savarino, Edoardo V.; Amorena, Edurne; Pérez‐Martínez, Isabel; Guagnozzi, Danila; Blas‐Jhon, Leonardo; Betoré, Elena; Guardiola‐Arévalo, Antonio; Pellegatta, Gaia; Krarup, Anne Lund; Perello, Antonia; Barrio, Jesús; Gutiérrez‐Junquera, Carolina; Sánchez‐Vegazo, Carlos Teruel; Fernández‐Fernández, Sonia; Naves, Juan Enrique; Oliva, Salvatore; Rodríguez‐Oballe, Juan Armando; Carrión, Silvia; Espina, Silvia; Barrio, Mónica Llorente; Masiques‐Mas, Maria Lluisa; Dainese, Raffaella; Feo‐Ortega, Sara; Martín‐Dominguez, Verónica; Fernández‐Pacheco, Jennifer; Pérez‐Fernández, Maria Teresa; Ghisa, Matteo; Maniero, Daria; Nantes‐Castillejo, Óscar; Nicolay‐Maneru, Julia; Suárez, Adolfo; Maray, Iván; Llerena‐Castro, Ronald; Ortega‐Larrodé, Adriana; Alcedo, Javier; Navacerrada, Alicia Granja; Racca, Francesca; Santander, Cecilio; Arias, Ángel; Lucendo, Alfredo J.
Source
United European Gastroenterology Journal. June, 2024, Vol. 12 Issue 5, p585, 11 p.
Subject
Language
English
Abstract
Background: Swallowed topical corticosteroids (tC) are common therapy for patients with eosinophilic esophagitis (EoE). Widely heterogeneous results have occurred due to their active ingredients, formulations and doses. Objective: To assess the effectiveness of topical corticosteroid therapy for EoE in real‐world practice. Methods: Cross‐sectional study analysis of the multicentre EoE CONNECT registry. Clinical remission was defined as a decrease of ≥50% in dysphagia symptom scores; histological remission was defined as a peak eosinophil count below 15 per high‐power field. The effectiveness in achieving clinico‐histological remission (CHR) was compared for the main tC formulations. Results: Overall, data on 1456 prescriptions of tC in monotherapy used in 866 individual patients were assessed. Of those, 904 prescriptions with data on formulation were employed for the induction of remission; 234 reduced a previously effective dose for maintenance. Fluticasone propionate formulations dominated the first‐line treatment, while budesonide was more common in later therapies. A swallowed nasal drop suspension was the most common formulation of fluticasone propionate. Doses ≥0.8 mg/day provided a 65% CHR rate and were superior to lower doses. Oral viscous solution prepared by a pharmacist was the most common prescription of budesonide; 4 mg/day provided no benefit over 2 mg/day (CHR rated being 72% and 80%, respectively). A multivariate analysis revealed budesonide orodispersible tablets as the most effective therapy (OR 18.9, p < 0.001); use of higher doses (OR 4.3, p = 0.03) and lower symptom scores (OR 0.9, p = 0.01) were also determinants of effectiveness. Conclusion: Reduced symptom severity, use of high doses, and use of budesonide orodispersible tablets particularly were all independent predictors of tC effectiveness.
Key summary Established knowledge * Topical corticosteroids (tC) are widely used to induce and maintain EoE remission in real practice. However, different products provide very heterogeneous results due to the [...]
Key summary Established knowledge * Topical corticosteroids (tC) are widely used to induce and maintain EoE remission in real practice. However, different products provide very heterogeneous results due to the [...]