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Esomeprazole for the Treatment of Erosive Esophagitis in Children: An International, Multicenter, Randomized,
Vasundhara Tolia1, Nader N Youssef, Mark A Gilger
1*Wayne State University, Detroit, MI †Atlantic Health, Morristown, NJ ‡Baylor College of Medicine, Houston, TX §AstraZeneca LP, Wilmington, DE.
Insights
Esomeprazole effectively healed erosive esophagitis in young children with gastroesophageal reflux disease. This study highlights its efficacy and potential histologic markers for pediatric reflux esophagitis.
Area of Science:
- Pediatric Gastroenterology
- Pharmacology
- Esophageal Pathology
Background:
- Proton pump inhibitors are standard for gastroesophageal reflux disease (GERD) and erosive esophagitis.
- Esomeprazole is increasingly used as first-line therapy for pediatric GERD.
- This study evaluates esomeprazole's efficacy in healing erosive esophagitis in young children.
Purpose of the Study:
- To assess the endoscopic healing of erosive esophagitis in children aged 1-11 years treated with esomeprazole.
- To describe esophageal histology in pediatric patients with GERD.
- To determine the effectiveness of esomeprazole in treating macroscopic and microscopic erosive esophagitis.
Main Methods:
- Children aged 1-11 years with confirmed GERD were randomized to receive esomeprazole (5-20 mg daily based on weight).
- Treatment duration was 8 weeks.
- Patients with erosive esophagitis underwent follow-up endoscopy to evaluate healing.
Main Results:
- Of 109 patients, 49% had erosive esophagitis.
- 89% of patients with erosive esophagitis achieved erosion resolution after 8 weeks of esomeprazole treatment.
- Dilation of intercellular space was observed in 24% of patients via histologic examination.
Conclusions:
- Esomeprazole (0.2-1.0 mg/kg) is effective in healing both macroscopic and microscopic erosive esophagitis in pediatric GERD patients.
- Dilation of intercellular space may serve as a significant histologic marker for erosive esophagitis in children.
- Esomeprazole demonstrates efficacy in managing pediatric GERD and associated esophageal damage.
Background:
Acid suppression with a proton pump inhibitor is standard treatment for gastroesophageal reflux disease and erosive esophagitis in adults and increasingly is becoming first-line therapy for children aged 1-17 years. We evaluated endoscopic healing of erosive esophagitis with esomeprazole in young children with gastroesophageal reflux disease and described esophageal histology.
Methods:
Children aged 1-11 years with endoscopically or histologically confirmed gastroesophageal reflux disease were randomized to esomeprazole 5 or 10 mg daily (< 20 kg) or 10 or 20 mg daily (≥ 20 kg) for 8 weeks. Patients with erosive esophagitis underwent an endoscopy after 8 weeks to assess healing of erosions.
Results:
Of 109 patients, 49% had erosive esophagitis and 51% had histologic evidence of reflux esophagitis without erosive esophagitis. Of the 45 patients who had erosive esophagitis and underwent follow-up endoscopy, 89% experienced erosion resolution. Dilation of intercellular space was reported in 24% of patients with histologic examination.
Conclusions:
Esomeprazole (0.2-1.0 mg/kg) effectively heals macroscopic and microscopic erosive esophagitis in this pediatric population with gastroesophageal reflux disease. Dilation of intercellular space may be an important histologic marker of erosive esophagitis in children.
