Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 26 September 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Predicting resistance to high-dose fluticasone in eosinophilic esophagitis

A study in August's issue of Gastroenterology evaluates the efficacy, dose reduction, and resistance to high-dose fluticasone in patients with eosinophilic esophagitis.

News image

Dr Marc Rothenberg and colleagues from Ohio, USA evaluated the efficacy and safety of high-dose swallowed fluticasone propionate, and dose reduction in patients with eosinophilic esophagitis.

The research team analyzed esophageal transcriptomes to identify mechanisms.

The researchers conducted a randomized, multisite, double-blind, placebo-controlled trial of daily 1760 mcg fluticasone propionate in participants age 3–30 years with active eosinophilic esophagitis.

The team reported that 28 participants received fluticasone propionate, and 14 participants received placebo.

After 3 months, participants given fluticasone propionate who were in complete remission received 880 mcg fluticasone propionate daily.

65% of subjects given fluticasone propionate were in complete remission after 3 months
Gastroenterology

Participants in the fluticasone propionate or placebo groups who were not in complete remission continued or started, respectively, 1760 mcg fluticasone propionate daily for 3 additional months.

The team's primary end point was histologic evidence for complete remission.

Secondary end points were partial remission, symptoms, compliance, esophageal gene expression, esophageal eosinophil count, and the relationship between clinical features and fluticason propionate responsiveness.

After 3 months, the team found that 65% of subjects given fluticasone propionate and no subjects given placebo were in complete remission.

The research team observed that 12% of those given fluticasone propionate, and 8% of those given placebo were in partial remission.

In the fluticasone propionate group, 73% of subjects remained in complete remission, and 20% were in partial remission after the daily dose was reduced by 50%.

Extending fluticasone propionate therapy in fluticasone propionate-resistant participants did not induce remission.

The researchers observed that fluticasone propionate decreased heartburn severity.

Compliance, age, sex, atopic status, or anthropomorphic features were not associated with response to fluticasone propionate.

Gene expression patterns in esophageal tissues of fluticasone propionate responders were similar to those of patients without EoE.

The researchers found evidence for heterogeneous steroid signaling in subjects who did not respond to fluticasone propionate, and preliminary evidence for transcripts predictive of fluticasone propionate responsiveness.

Dr Rothenberg's team commented, "Daily administration of a high dose of fluticasone propionate induces histologic remission in 65%–77% of patients with eosinophilic esophagitis after 3 months."

"A 50% dose reduction remained effective in 73%–93% of patients who initially responded to fluticasone propionate."

"Nonresponders had evidence of steroid resistance."

"Histologic and molecular markers may predict resistance."

Gastroenterol 2014: 147(2): 324–333.e5
29 July 2014

Go to top of page Email this page Email this page to a colleague

 26 September 2016 
Preventing cirrhosis in Hep C with fibrosis
 26 September 2016 
Body image after abdominoperineal excision for rectal cancer
 26 September 2016 
Gastric cancer risk in intestinal metaplasia of the stomach
 23 September 2016 
Sleep quality in nonalcoholic cirrhotic patients
 23 September 2016 
Exercise for NAFLD
 23 September 2016 
BMI history and fatty liver
 22 September 2016 
Predicting small-bowel Crohn’s disease
 22 September 2016 
Colectomy outcomes for ulcerative colitis
 22 September 2016 
Technology vs intervention for weight loss
 21 September 2016 
Cardiopulmonary exercise testing in liver transplant candidates
 21 September 2016 
Employment status and IBD
 21 September 2016 
Patients vs providers on nutrition in IBD
 20 September 2016 
Improving healthcare systems for viral Hepatitis
 20 September 2016 
GI benefits of COX-2 selective inhibitors
 20 September 2016 
Predicting relapse in Crohn's
 19 September 2016 
Prevalence of esophageal cancer in Barrett's
 19 September 2016 
Fecal microbiota transplantation and CDI in IBD
 19 September 2016 
Antibiotic resistance in Helicobacter pylori
 16 September 2016 
Low-residue diet before colonoscopy and bowel cleansing
 16 September 2016 
Genome-wide association in gastric cancer
 16 September 2016 
H. pylori in children with asthma
 15 September 2016 
Improving survival in cholangitis-associated septic shock
 15 September 2016 
Colorectal cancer survival and hospital volumes
 15 September 2016 
Primary sclerosing cholangitis and IBD
 14 September 2016 
Intestinal malabsorption and olmesartan
 14 September 2016 
Infection reduction strategy after colorectal resection
 14 September 2016 
Predicting long-term infliximab use in Crohn's
 13 September 2016 
Predicting survival in refractory celiac disease
 13 September 2016 
Cancer risk stratification in Barrett’s
 13 September 2016 
Screening vs non-screening colonoscopy
 12 September 2016 
Screening in familial colorectal cancer
 12 September 2016 
Metformin improves survival in pancreatic ductal cancer
 12 September 2016 
Consent guidelines for GI endoscopy procedures
 09 September 2016 
Development of IBS
 09 September 2016 
Safe and effective treatment for NASH
 09 September 2016 
Scale for stool measurement in diarrhea-IBS
 08 September 2016 
Prognostic factors for infliximab in Crohn's
 08 September 2016 
Chronic Hep B vs chronic Hep C and mortality
 08 September 2016 
Hematological malignancies in IBD
 07 September 2016 
IBD relapse during pregnancy
 07 September 2016 
New treatments for ulcerative colitis
 07 September 2016 
Alternative to nucleic acid testing in HCV
 06 September 2016 
Endoscopy clinic no-shows
 06 September 2016 
Risk of infection after elective colorectal surgery
 06 September 2016 
EHealth technologies in IBD
 05 September 2016 
Esophageal impedance monitoring
 05 September 2016 
Family history and IBD clinical course
 05 September 2016 
Biomarker for IBD and GI cancer
 02 September 2016 
Dietary carbohydrate intake, insulin resistance and GERD 
 02 September 2016 
Postpolypectomy bleeding in the colorectum
 02 September 2016 
Postop recurrence of Crohn's
 01 September 2016 
Prognostic test for liver transplants
 01 September 2016 
Recovery after colorectal surgery in elderly patients
 01 September 2016 
Obesity and post-ERCP pancreatitis
 30 August 2016 
NAFLD and carotid atherosclerosis
 30 August 2016 
Quality improvement program after colorectal surgery
 30 August 2016 
Gut microbial diversity in smokers with Crohn's
 29 August 2016 
Reducing Hep B-related HCC
 29 August 2016 
Hep B immunization of infants for liver cancer
 29 August 2016 
Risk factor for post-ERCP pancreatitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us