title: Oral viscous budesonide: a potential new therapy for eosinophilic esophagitis in children.
abstract: BACKGROUND
  Eosinophilic esophagitis (EE) is a disorder characterized typically by pan-esophageal eosinophilia. We evaluate a palatable, long-acting topical corticosteroid preparation for the treatment of EE.
  
  
  METHODS
  This is a retrospective analysis of symptoms, endoscopic and histologic findings, efficacy, and safety of treatment in children with EE receiving oral viscous budesonide. Response to therapy was determined histologically by the number of eos/hpf. Patients were classified by histology into responders (0-7 eos/hpf), partial responders (8-23 eos/hpf), and nonresponders (>/=24 eos/hpf). A symptom score (max. 14) and an EE endoscopy score (max. 8) were used to compare data.
  
  
  RESULTS
  In 20 children (mean age 5.5 yr, median age 4.1 yr) the mean highest eosinophil count was 87 eos/hpf (range 30-170) before and 7 eos/hpf (range 0-50, P < 0.0001) after therapy. There were 16 (80%) responders, 1 partial responder, and 3 nonresponders. Commonest pretreatment symptoms were nausea, vomiting, pain, and heartburn. The mean symptom score fell from 4.4 to 0.8 (P < 0.0001) and the mean endoscopy score from 3.6 to 0.8 (P < 0.0001). No significant adverse events were reported. Morning cortisol levels were within normal limits.
  
  
  CONCLUSIONS
  Topical viscous budesonide is a safe and effective therapy for EE in young children.
authors.affiliation: Division of Allergy and Immunology, Children's Hospital, San Diego, La Jolla, California, USA.
authors.forename: Seema S
authors.initials: SS
authors.lastname: Aceves
authors.forename: John F
authors.initials: JF
authors.lastname: Bastian
authors.forename: Robert O
authors.initials: RO
authors.lastname: Newbury
authors.forename: Ranjan
authors.initials: R
authors.lastname: Dohil
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D019819:Budesonide / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004802:Eosinophilia / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D004941:Esophagitis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013535:Suspensions; D016896:Treatment Outcome; D014783:Viscosity
chemical_list: D005938:Glucocorticoids; D013535:Suspensions; D019819:Budesonide