Comparison of Oral Prednisone and Topical Fluticasone in the Treatment of Eosinophilic Esophagitis: A Randomized Trial in Children

摘要: Background & Aims: Although eosinophilic esophagitis is recognized increasingly, outcome data guiding therapy are limited. We conducted a prospective randomized trial comparing oral prednisone (P) and swallowed fluticasone (F) for histologic clinical response. Methods: Patients were to receive P or F 4 weeks, followed by an 8-week weaning protocol. Esophageal histology was evaluated at baseline after weeks of therapy. Clinical assessments performed 0, 4, 12, 18, 24. Results: Eighty patients with enrolled: 40 in the arm arm. Histologic improvement seen 30 32 34 36 patients, greater degree group. All 35 free presenting symptom(s) week 4. Symptom relapse 45% Kaplan–Meier analysis showed no difference between regard rate (P = .7399). No significant time found groups .2529). Systemic adverse effects noted 40% arm, whereas esophageal candidal overgrowth 15% Conclusions: topical corticosteroids effective achieving initial improvement. resulted improvement, without evidence associated advantage over terms symptom resolution, rates, relapse. common both upon discontinuation, highlighting need maintenance treatment protocols.