PMID- 26939578
OWN - NLM
STAT- MEDLINE
DCOM- 20161024
LR  - 20220317
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Linking)
VI  - 43
IP  - 9
DP  - 2016 May
TI  - A prospective open clinical trial of a proton pump inhibitor, elimination diet 
      and/or budesonide for eosinophilic oesophagitis.
PG  - 985-93
LID - 10.1111/apt.13576 [doi]
AB  - BACKGROUND: Elimination diets and high-dose proton pump inhibitors (PPI) are 
      advocated as first-line treatments in patients with eosinophilic oesophagitis 
      (EoE). AIM: To record the treatment outcome for patients with EoE prospectively 
      managed according to a clinical algorithm. METHODS: Patients with oesophageal 
      eosinophilia commenced esomeprazole 40 mg twice daily for 8 weeks. Those in 
      histological remission were re-classified as PPI-responsive oesophageal 
      eosinophilia. Nonresponders were offered the 6-food elimination diet with a PPI, 
      or topical budesonide monotherapy (1 mg orally twice daily as an aqueous gel). 
      Once disease control was achieved remission was reassessed at 3 months (all 
      modalities) and an additional 6 months (diet group). RESULTS: Of 107 patients who 
      completed 8 weeks of PPI, 25 (23%) were PPI-responsive. 56 of 81 (69%) of 
      patients with EoE chose the elimination diet with PPI. 29 (52%) had complete 
      remission, 23 completed dietary reintroduction and food triggers were identified 
      in 20 (36%). 25 chose budesonide with 23/25 (92%) responding. Remission was 
      sustained in >85% of patients at 3 months with all treatment modalities. At 9 
      months, only 10/18 (55%) of patients who responded to the elimination diet with 
      PPI remained complaint and sustained remission. CONCLUSIONS: Many patients 
      previously diagnosed with EoE will respond to PPI. Initial response >50% is 
      possible with the elimination diet plus PPI, but many will fail to undergo food 
      reintroduction, or will cease the diet and relapse, resulting in only one in four 
      patient sustaining remission at 9 months. Budesonide is very effective short 
      term, but longer term study is needed.
CI  - (c) 2016 John Wiley & Sons Ltd.
FAU - Philpott, H
AU  - Philpott H
AD  - Monash University, Melbourne, Vic., Australia.
AD  - Eastern Health, Melbourne, Vic., Australia.
AD  - The Alfred Hospital, Melbourne, Vic., Australia.
FAU - Nandurkar, S
AU  - Nandurkar S
AD  - Monash University, Melbourne, Vic., Australia.
AD  - Eastern Health, Melbourne, Vic., Australia.
FAU - Royce, S G
AU  - Royce SG
AD  - Monash University, Melbourne, Vic., Australia.
FAU - Thien, F
AU  - Thien F
AD  - Monash University, Melbourne, Vic., Australia.
AD  - Eastern Health, Melbourne, Vic., Australia.
FAU - Gibson, P R
AU  - Gibson PR
AD  - Monash University, Melbourne, Vic., Australia.
AD  - The Alfred Hospital, Melbourne, Vic., Australia.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20160304
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - 51333-22-3 (Budesonide)
RN  - N3PA6559FT (Esomeprazole)
SB  - IM
CIN - Aliment Pharmacol Ther. 2016 Jul;44(1):98-100. PMID: 27250590
CIN - Aliment Pharmacol Ther. 2016 Jul;44(1):100-1. PMID: 27250591
CIN - Aliment Pharmacol Ther. 2016 Jul;44(2):198-9. PMID: 27296680
CIN - Aliment Pharmacol Ther. 2016 Jul;44(2):199-200. PMID: 27296681
MH  - Adult
MH  - Anti-Inflammatory Agents/administration & dosage/*therapeutic use
MH  - Budesonide/administration & dosage/*therapeutic use
MH  - Combined Modality Therapy
MH  - Eosinophilic Esophagitis/*diet therapy/*drug therapy
MH  - Esomeprazole/administration & dosage/*therapeutic use
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/administration & dosage/*therapeutic use
MH  - Recurrence
MH  - Remission Induction
MH  - Treatment Outcome
EDAT- 2016/03/05 06:00
MHDA- 2016/10/25 06:00
CRDT- 2016/03/05 06:00
PHST- 2016/01/03 00:00 [received]
PHST- 2016/01/13 00:00 [revised]
PHST- 2016/01/19 00:00 [revised]
PHST- 2016/02/07 00:00 [revised]
PHST- 2016/02/09 00:00 [accepted]
PHST- 2016/03/05 06:00 [entrez]
PHST- 2016/03/05 06:00 [pubmed]
PHST- 2016/10/25 06:00 [medline]
AID - 10.1111/apt.13576 [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2016 May;43(9):985-93. doi: 10.1111/apt.13576. Epub 2016 
      Mar 4.