Diagnostic and Therapeutic Long-term Management of Eosinophilic Esophagitis—Current Concepts and Perspectives for Steroid Use

Thomas Greuter, Jeffrey A. Alexander, Alex Straumann, David A Katzka

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus, which requires short- and long-term treatment. In addition, patients under long-term treatment for any chronic condition should have a structured follow-up. The mainstays in EoE treatment are drugs (such as swallowed topical corticosteroids [STC] and proton pump inhibitors), dietary exclusions, and endoscopic dilations. STC are the most widely used treatment and have proven efficacy in inducing clinical, endoscopic and histological remission in active EoE. However, data regarding maintaining disease remission and long-term management are limited. Ongoing disease activity and relapses despite STC treatment are frequently observed. This sheds light on the urgent need for adequate maintenance strategies, which have not been well defined. In terms of follow-up concepts, to date neither guidelines nor consensus recommendations have been published. To summarize the current knowledge on long-term diagnostic and therapeutic STC management of EoE, we conducted a literature search using PubMed and Embase applying the following key search items: Eosinophilic esophagitis, eosinophils, esophagus, swallowed topical corticosteroids, fluticasone, budesonide, long-term, treatment, therapy, and follow-up. In addition, we present empirically developed long-term management concepts applied at two large EoE centers, with a special focus on STC treatments. Finally, we highlight areas of future research and perspectives regarding the long-term management of EoE.

Original languageEnglish (US)
Article number212
JournalClinical and Translational Gastroenterology
Volume9
Issue number12
DOIs
StatePublished - Dec 1 2018

Fingerprint

Eosinophilic Esophagitis
Steroids
Adrenal Cortex Hormones
Therapeutics
Esophagus
Budesonide
Proton Pump Inhibitors
Eosinophils
PubMed
Dilatation
Chronic Disease
Maintenance
Guidelines
Recurrence

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Diagnostic and Therapeutic Long-term Management of Eosinophilic Esophagitis—Current Concepts and Perspectives for Steroid Use. / Greuter, Thomas; Alexander, Jeffrey A.; Straumann, Alex; Katzka, David A.

In: Clinical and Translational Gastroenterology, Vol. 9, No. 12, 212, 01.12.2018.

Research output: Contribution to journalReview article

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