Division of Gastroenterology & Hepatology, Department of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania Perelman School of Medicine, 7th Floor South Pavilion PCAM, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Division of Allergy and Immunology, Department of Pediatrics, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, 13 Children's Way, Slot 512-13, Little Rock, AR 72202, USA.
Immunol Allergy Clin North Am. 2024 May;44(2):245-264. doi: 10.1016/j.iac.2023.12.010. Epub 2024 Jan 23.
Proton pump inhibitors (PPIs), swallowed topical corticosteroids (STSs), and dupilumab are highly effective therapies for the treatment of eosinophilic esophagitis. Shared decision-making informs the choice of therapy and factors such as ease of use, safety, cost, and efficacy should be addressed. PPIs are the most common medication utilized early in the disease course; however, for nonresponders, STSs are an excellent alternative. Dupilumab is unlikely to replace PPIs or STSs as first-line therapy, except in highly specific circumstances. Identification of novel biologic pathways and the development of small molecules may lead to a wider range of treatment options in the future.
质子泵抑制剂(PPIs)、口服局部皮质类固醇(STSs)和度普利尤单抗是治疗嗜酸性食管炎的有效疗法。共同决策告知治疗选择,应考虑易用性、安全性、成本和疗效等因素。PPI 是疾病早期最常用的药物;然而,对于无应答者,STSs 是一种极好的替代药物。度普利尤单抗不太可能取代 PPI 或 STS 作为一线治疗药物,除非在特定情况下。识别新的生物学途径和小分子的开发可能会导致未来有更广泛的治疗选择。