A Randomized, Double-Blind, Placebo-Controlled Trial of Fluticasone Propionate for Pediatric Eosinophilic Esophagitis

Konikoff, Michael R.; Noel, Richard J.; Blanchard, Carine; Kirby, Cassie L.; Jameson, Sean C.; Buckmeier, Bridget K.; Akers, Rachel; Cohen, Mitchell B.; Collins, Margaret H.; Assa’ad, Amal; Aceves, Seema S.; Putnam, Philip E.; Rothenberg, Marc E.

doi:10.1053/j.gastro.2006.08.033

Cited by 531 publications

(506 citation statements)

References 33 publications

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“…These patients showed improved symptoms and also significant change in follow-up esophageal eosinophilia count [53]. In a 2006 RCT of 21 EoE pediatric patients that were treated with fluticasone, 50% achieved histologic remission defined as a peak eosinophil count of < 1 eosinophil / HPF, versus only 9% of patients receiving placebo (P=0 .047) [54]. Similar findings of symptomatic improvement were seen in adult patients receiving fluticasone [55].…”

Section: Steroidsmentioning

confidence: 66%

Eosinophilic Esophagitis–More than Two Decades of Progress

Rahimi

Ertan

2015

JGPLD

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Section: Steroidsmentioning

confidence: 66%

Eosinophilic Esophagitis–More than Two Decades of Progress

Rahimi

Ertan

2015

JGPLD

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“…The scores ranged from 50% 20 to 100% 21. Approximately 50% of the studies were of high quality, having quality measures scores of 70% or above.…”

Section: Resultsmentioning

confidence: 99%

“…diet elimination or restriction), we observed that medication trial studies (e.g. steroids, monoclonal antibody) used more rigorous criteria in their definition of histological remission in study subjects with EoE 21, 26, 27, 35, 53, 60. It is possible that different cut‐off values of peak eosinophil counts per hpf are appropriate for the definition of histological improvement because of the variations in the trial methodology (treatment, subjects’ characteristics).…”

Section: Discussionmentioning

confidence: 99%

Systematic review of histological remission criteria in eosinophilic esophagitis

Eke

White

et al. 2018

JGH Open

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Elemental diets, dietary elimination, and steroid therapies are the most common therapies in the clinical trials for eosinophilic esophagitis (EoE). Histological findings (usually reported as eosinophils per microscopic high‐powered field [hpf]) remain the most common end‐point used to define response. Yet, the threshold for defining “response” and “remission” are ill‐defined among consensus guidelines and may vary from study to study. We conducted a systematic literature review of articles on eosinophilic esophagitis, published between January 2007 and November 2017, considering histological remission as the primary outcome. We abstracted treatment information and definitions of histological remission or response. A comparison of definitions of histological remission across and within institutions was performed. A total of 61 articles were included in this review, with approximately 60% of the studies published from centers in the United States. Histological definitions of remission of EoE ranged from 0 to ≤20 eosinophils/hpf. The most stringent criteria, ranging from 0 to ≤5 eosinophils/hpf, were commonly used in interventional trial studies that examined the effects of new treatments. We found remarkable variability in definitions between studies, treatment types, and regions. Age or epidemiological distribution of study subjects did not influence the criteria for histological remission. Clinical and histological improvements are important measures of the effects of treatment. Histological findings, the most objective measure of treatment, should provide an optimal method for comparing the effectiveness of various treatments. Yet, our findings suggest a lack of consistent remission criteria in published studies. Considering these inconsistencies, it is difficult to compare the effectiveness of various treatments.

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“…effects, both swallowed fluticasone propionate administered via a metered dose inhaler and oral viscous budesonide have been used and shown to be effective for both symptomatic and histological improvement [13,14].…”

Section: Infective Esophagitis: Inhaled Steroids Treatment For Eosinomentioning

confidence: 99%

Infective Esophagitis: Inhaled Steroids Treatment for Eosinophilic Esophagitis not Always Safe

Zala¹,

Wauters²,

Vanuytsel³

et al. 2017

GHOA

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A Randomized, Double-Blind, Placebo-Controlled Trial of Fluticasone Propionate for Pediatric Eosinophilic Esophagitis

Cited by 531 publications

References 33 publications

Eosinophilic Esophagitis–More than Two Decades of Progress

Eosinophilic Esophagitis–More than Two Decades of Progress

Systematic review of histological remission criteria in eosinophilic esophagitis

Infective Esophagitis: Inhaled Steroids Treatment for Eosinophilic Esophagitis not Always Safe

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