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Montelukast was inefficient in maintaining steroid-induced remission in adult eosinophilic esophagitis.
- Source :
-
Digestive Diseases & Sciences . Dec2011, Vol. 56 Issue 12, p3551-3558. 8p. - Publication Year :
- 2011
-
Abstract
- <bold>Background and Aims: </bold>Leukotriene D4 is produced by and functions as a chemotactic factor for eosinophils. Eosinophilic esophagitis (EoE) is characterized by esophageal eosinophilic infiltration, determining structural changes and dismotility symptoms. Montelukast, a selective leukotriene D4 receptor antagonist, has gained increasing consideration as a therapeutic agent for EoE. However, limited available information has shown that montelukast is not effective in reducing eosinophilic infiltration. Our paper aims at evaluating whether montelukast could be consider as a steroid-sparing therapy by assessing its efficacy in maintaining both clinical and histopathological remission achieved after topical corticosteroids in adult EoE patients.<bold>Methods: </bold>Eleven consecutively diagnosed adult EoE patients were prospectively studied. Esophageal biopsies were obtained before and after a 6-month treatment with fluticasone propionate 400 μg/twice a day. Immediately after that, montelukast 10 mg/day was instituted. A new endoscopy was foreseen after a new 3-month period, or as soon as the patients presented esophageal symptoms. Symptoms were assessed by using a questionnaire before and after fluticasone propionate treatment and after montelukast therapy.<bold>Results: </bold>Eosinophils density into the esophageal epithelium and lamina propria was significantly reduced after a 6-month treatment with topical steroids (P = 0.003) and increased to levels similar to baseline level into the first 3 months after treatment with montelukast. Baseline symptom scores significantly decreased after treatment with topical steroids (P = 0.003) and increased again after montelukast therapy, but baseline levels improved.<bold>Conclusions: </bold>Montelukast was not efficient in maintaining the histopathological or clinical response achieved by topical steroids in adult EoE patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- *STEROID drugs
*GASTROESOPHAGEAL reflux in children
*LEUKOTRIENES
*BIOPSY
*ENDOSCOPY
*CLINICAL trials
*ACETIC acid
*ANTI-inflammatory agents
*COMBINATION drug therapy
*COMPARATIVE studies
*DOSE-effect relationship in pharmacology
*LONGITUDINAL method
*RESEARCH methodology
*MEDICAL cooperation
*PATIENT satisfaction
*QUINOLINE
*RESEARCH
*STEROIDS
*EVALUATION research
*TREATMENT effectiveness
*DISEASE remission
*ENDOSCOPIC gastrointestinal surgery
*EOSINOPHILIC esophagitis
*LEUKOTRIENE antagonists
*THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 01632116
- Volume :
- 56
- Issue :
- 12
- Database :
- Academic Search Index
- Journal :
- Digestive Diseases & Sciences
- Publication Type :
- Academic Journal
- Accession number :
- 67648444
- Full Text :
- https://doi.org/10.1007/s10620-011-1775-y