Department of Gastroenterology, North Denmark Regional Hospital, Hjørring, Denmark.
Department of Emergency Medicine and Trauma Center, Aalborg University Hospital, Aalborg, Denmark.
Scand J Gastroenterol. 2024 Oct;59(10):1137-1143. doi: 10.1080/00365521.2024.2395865. Epub 2024 Sep 12.
Eosinophilic oesophagitis (EoE) is a chronic immune-mediated disease. In Denmark, the budesonide orodispersible tablet (BOT) is recommended as a second-line treatment for proton pump inhibitor-refractory EoE patients.
To evaluate the effectiveness of treatment with BOT in adult EoE patients in a population-based setting in Denmark.
This was a retrospective, registry-based, DanEoE cohort study of all 76 adult EoE patients treated with BOT and diagnosed between 2007 and 2021 in the North Denmark Region. After medical record revision, the EoE diagnosis was defined according to the AGREE consensus. Symptomatic response was based on the information found in the patients' medical reports and histologic remission was defined as <15 eosinophils per high-power field (eos/hpf).
Histologic remission was achieved in 89% of the patients treated with BOT who underwent histologic evaluation. Clinicohistologic remission was achieved in 71% of the patients who underwent both symptomatic and histologic evaluation. Despite histologic remission, 18% of patients still experienced symptoms. Non-responders were found in 7% of the patients. Complications were rare, with dilation of strictures performed in 7% and food bolus obstruction (FBO) occurring in 3%. Discontinuation of the treatment due to unacceptable side effects was observed in 11% of the treated patients.
Treatment with BOT effectively induced histologic remission in most of the EoE patients. Despite achieving histologic remission, approximately 1/5 of the patients were still symptomatic. Complications were rare. In non-responders and those with unacceptable side effects, alternative treatment options such as biologic agents might be needed.
嗜酸性食管炎（EoE）是一种慢性免疫介导性疾病。在丹麦，布地奈德口崩片（BOT）被推荐作为质子泵抑制剂难治性 EoE 患者的二线治疗药物。
评估在丹麦基于人群的环境中，BOT 治疗成人 EoE 患者的疗效。
这是一项回顾性、基于登记的丹麦嗜酸性食管炎队列研究，纳入了 2007 年至 2021 年期间在北丹麦地区接受 BOT 治疗且被诊断为 EoE 的 76 例成年患者。在病历修订后，根据 AGREE 共识定义 EoE 诊断。症状缓解基于患者病历中的信息，组织学缓解定义为每高倍视野（hpf）<15 个嗜酸性粒细胞（eos/hpf）。
接受组织学评估的 BOT 治疗患者中，有 89%达到组织学缓解。接受症状和组织学评估的患者中，有 71%达到临床-组织学缓解。尽管达到组织学缓解，但仍有 18%的患者存在症状。7%的患者被认为是无应答者。并发症罕见，仅 7%的患者需要进行狭窄扩张，3%的患者发生食物团块梗阻（FBO）。由于无法耐受的副作用，有 11%的治疗患者停止了治疗。
BOT 治疗可有效诱导大多数 EoE 患者的组织学缓解。尽管达到组织学缓解，但仍有约 1/5的患者存在症状。并发症罕见。对于无应答者和无法耐受副作用的患者，可能需要选择其他治疗方案，如生物制剂。
