title: Therapeutic strategies in eosinophilic esophagitis: Induction, maintenance and refractory disease.
abstract: Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disease that is increasingly recognized as one of the most common causes of dysphagia and foregut symptoms in adults and children. Topical corticosteroids, elimination diets, and esophageal dilations are effective options for both induction and maintenance therapy in EoE. Current pharmacologic options are being used off-label as no agent has yet been approved by regulatory authorities. Little is known about the natural history of EoE, however, raising controversy regarding the necessity of maintenance and therapy in asymptomatic or treatment-refractory patients. Furthermore, variability in treatment endpoints used in EoE clinical trials makes interpretation and comparability of EoE treatments challenging. Recent validation of a patient-related outcome (PRO) instruments, a histologic scoring tool, and an endoscopic grading system for EoE are significant advances toward establishing consistent treatment endpoints.
authors.affiliation: Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA.
authors.forename: Jamie
authors.initials: J
authors.lastname: Sodikoff
authors.affiliation: Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA. Electronic address: i-hirano@northwestern.edu.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Hirano
mesh_terms: D003680:Deglutition Disorders / Q000209:etiology; D004035:Diet Therapy; D004106:Dilatation / Q000379:methods; D057765:Eosinophilic Esophagitis / Q000150:complications / Q000628:therapy*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans
chemical_list: D005938:Glucocorticoids
keywords: Dysphagia; Eosinophilic esophagitis; Eosinophilic gastroenteritis; Esophageal dilation; Esophageal stricture; Gastroesophageal reflux disease