Viscous topical vs nebulized steroid therapy in eosinophilic esophagitis

Viscous topical is more effective than nebulized steroid therapy for patients with eosinophilic esophagitis, reports August's issue of Gastroenterology.

Dr Evan Dellon and colleagues from North Carolina, USA performed a randomized trial to compare nebulized and viscous topical corticosteroid treatments for eosinophilic esophagitis.

Subjects with incident eosinophilic esophagitis received budesonide 1 mg twice daily, either nebulized and then swallowed or as an oral viscous slurry, for 8 weeks.

The research team found that baseline eosinophil counts for the nebulized and then swallowed, and oral viscous slurry groups were 101 and 83.

Mucosal medication contact time was higher for the oral viscous slurry group

Gastroenterology

The researchers noted that posttreatment counts were 89 and 11.

The mucosal medication contact time, measured by scintigraphy, was higher for the oral viscous slurry group than the nebulized and then swallowed group, and was inversely correlated with eosinophil count.

OVB was more effective than nebulized and then swallowed in reducing numbers of esophageal eosinophils in patients with eosinophilic esophagitis.

Dr Dellon's team concludes, "Oral viscous slurry provided a significantly higher level of esophageal exposure to the therapeutic agent, which correlated with lower eosinophil counts."