A Novel Therapy of Eosinophilic Esophagitis-Treatment of Eosinophilic Esophagitis Using a Single Dose of Intramuscular Corticosteroid and Proton Pump Inhibitor

Abstract

Background: Ee (Eosinophilic esophagitis) is an inflammatory condition characterized by a dense eosinophilic infiltrate in the esophageal epithelium. Its pathophysiology mimics that of allergic esophagitis, and evolves clinically as a chronic disease with periods of exacerbation. Symptoms and endoscopic findings are usually non-specific and similar to those of other esophageal illnesses. The mainstay of treatment of Ee is with corticosteroids and/or specific diets, which have been shown to cause symptom remission and histological improvement. Aim: The objective of this study was to demonstrate the efficacy of a novel and promising treatment protocol for Ee. Materials and methods: We prospectively evaluated 24 patients with Ee over two years. Patients were treated with a single intramuscular injection of betamethasone sodium phosphate associated with betamethasone dipropionate and a PPI (proton pump inhibitor) (rabeprazole 20 mg PO). After 4 weeks of treatment, patients underwent endoscopy and biopsy. We evaluated patients' clinical response as well as the results of endoscopic and histological examinations. Results: After 4 weeks of treatment, all patients (100%) are reported significant clinical improvement, which was corroborated by the findings on endoscopy and histology. There were no complications or adverse reactions. Conclusions: In this cohort of patients with eosinophilic esophagitis, treatment with a single intramuscular dose of corticosteroids led to complete remission of symptoms and improvement in endoscopic and histological findings.