Treatment with compounded fluticasone suspension improves the clinical, endoscopic, and histologic features of eosinophilic esophagitis
| Autor: | Craig C. Reed, Evan S. Dellon, Corey J. Ketchem, Zoe Stefanadis |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Population Chest pain Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Eosinophilic esophagitis education Fluticasone Retrospective Studies education.field_of_study business.industry Medical record Heartburn Retrospective cohort study General Medicine Eosinophilic Esophagitis medicine.disease Dysphagia Treatment Outcome 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Female Original Article Esophagoscopy medicine.symptom business medicine.drug |
| Zdroj: | Dis Esophagus |
| ISSN: | 1442-2050 |
| Popis: | Summary No approved medication exists for the treatment of eosinophilic esophagitis (EoE) in the United States, which forces patients to utilize off-label drugs and/or create their own formulations. We assessed the efficacy of a standardized compounded fluticasone suspension. To do this, we performed a retrospective cohort study identifying all EoE patients treated with compounded fluticasone. Compounded fluticasone was prescribed during routine clinical care and dispensed by a specialty compounding pharmacy. Clinical data were extracted from medical records. Outcomes (symptomatic, endoscopic, and histologic) were assessed after the initial and last compounded fluticasone treatment in our system. There were 27 included patients (mean age 34.2; 67% male; 96% white) treated for a mean length of 5.4 ± 4.4 months. The majority (89%) previously utilized dietary elimination or topical corticosteroids, and many (75%) had primary non-response or secondary loss of response to these treatments. After starting compounded fluticasone, symptoms and endoscopic findings improved [dysphagia (89 vs. 56%, P = 0.005), food impaction (59 vs. 4%, P = 0.003), heartburn (26 vs. 4%, P = 0.01), chest pain (26 vs. 8%, P = 0.05), white plaques (63 vs. 32%; P = 0.005), furrows (81 vs. 60%; P = 0.06), and edema (15 vs. 4%; P = 0.16)]. The median of the peak eosinophil counts decreased from 52 to 37 eos/hpf (P = 0.10) and 35% of patients achieved |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|