Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton 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 March 2015

Advanced search
 26 March 2015 
Antimicrobial therapy in cirrhosis with spontaneous bacterial peritonitis
 26 March 2015 
Metformin as a chemopreventive agent for Barrett's
 26 March 2015 
Survival of untreated hepatocellular carcinoma
 25 March 2015 
Genetics and Crohn's disease
 25 March 2015 
Mortality in Barrett’s–related T1 esophageal adenocarcinoma
 25 March 2015 
Cytomegalovirus and IBD
 24 March 2015 
Prevention of colorectal cancer after screening
 24 March 2015 
Functional GI disorders and body mass index
 24 March 2015 
Quality of life in children with fecal incontinence
 23 March 2015 
Fibrosis in NAFLD vs NASH
 23 March 2015 
The unmasking of Whipple's disease
 23 March 2015 
Predicting the quality of colon cancer care
 20 March 2015 
Interventions for eosinophilic esophagitis
 20 March 2015 
Colorectal cancer risk and genetic variants
 20 March 2015 
Screening for Barrett's esophagus
 19 March 2015 
Hypnotherapy for IBS
 19 March 2015 
Poor mental and physical health in HCV
 19 March 2015 
Dedicated care for diverticular disease
 18 March 2015 
Practice guidelines for colorectal polyps
 18 March 2015 
Out-of-hours endoscopy for upper GI bleeding
 18 March 2015 
H. pylori eradication and lipids
 17 March 2015 
H. pylori test-and-treat program and gastric cancer
 17 March 2015 
Adalimumab in Crohn’s disease
 17 March 2015 

Low-dose PPIs and GI bleeding in patients receiving aspirin

 16 March 2015 
Microscopic colitis
 16 March 2015 
Cholestasis of pregnancy with HCV
 16 March 2015 
Hybrid therapy for H. pylori
 13 March 2015 
Medicare patients and payments to gastroenterologists
 13 March 2015 
Appendectomy in ulcerative colitis
 13 March 2015 

Racial disparities in gluten-sensitive problems

 12 March 2015 
Predicting IBD in IBS patients
 12 March 2015 
Patient knowledge of IBS
 12 March 2015 
Nonceliac gluten sensitivity
 11 March 2015 

Prediction of malignant bile duct obstruction

 11 March 2015 
NAFLD–related hepatocellular carcinoma
 11 March 2015 
Assessment of eosinophilic esophagitis
 10 March 2015 
Risk for gastroesophageal reflux symptoms
 10 March 2015 
Poor disease course in pediatric ulcerative colitis
 10 March 2015 
Outcomes in Crohn's therapy
 09 March 2015 
Fibre usage in ulcerative colitis in remission
 09 March 2015 
Gastric Cancer detection during GI endosocopy
 09 March 2015 
Risk of C. difficile upon hospital admission
 06 March 2015 
Second anti-TNF in IBD
 06 March 2015 
Efficacy of Hep E vaccine
 06 March 2015 
Steroid therapy for eosinophilic esophagitis
 05 March 2015 
EPHXI polymorphism and esophageal cancer risk
 05 March 2015 
Infliximab and immunosuppressant therapy in ulcerative colitis
 05 March 2015 
Neuroendocrine carcinoma of the colon and rectum
 04 March 2015 
Multidisciplinary management of rectal cancer
 04 March 2015 
Management of IBD
 04 March 2015 
Progression of Barrett's
 03 March 2015 
EPHX1 polymorphism and esophageal cancer risk
 03 March 2015 
GI bleeding in chronic kidney disease patients on aspirin
 03 March 2015 
Risk of anastomotic leak after colectomy
 02 March 2015 
Genes and early diagnosis of IBD
 02 March 2015 
Assessment of GERD
 02 March 2015 
Liver disease in patients awaiting liver transplant
 27 February 2015 
Obesity and weight-loss therapy
 27 February 2015 
MRE performance in staging liver fibrosis
 27 February 2015 
Bleeding in diverticulosis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us