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Updated: Jan 30, 2026
Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
Published on: May 10, 2024
A 12-Week Maintenance Therapy with a New Prepared Viscous Budesonide in Pediatric Eosinophilic Esophagitis
Salvatore Oliva1, Danilo Rossetti2, Paola Papoff3
1Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. salvatore.oliva@uniroma1.it.
Insights
Prepared oral viscous budesonide (PVB) effectively maintained remission in pediatric eosinophilic esophagitis (EoE) for 12 weeks. However, relapse rates increased after treatment suspension, indicating PVB may not prevent long-term recurrence.
Area of Science:
- Gastroenterology
- Pediatric Allergy and Immunology
- Pharmacology
Background:
- Pediatric eosinophilic esophagitis (EoE) is a chronic inflammatory condition.
- Prepared oral viscous budesonide (PVB) has shown efficacy in inducing remission for EoE.
- Optimal maintenance strategies for pediatric EoE are still under investigation.
Purpose of the Study:
- To assess the efficacy of a 12-week maintenance therapy using a reduced dose of PVB in pediatric EoE patients.
- To evaluate the impact of maintenance therapy on clinical, endoscopic, and histological remission.
- To monitor remission rates and relapse following cessation of PVB treatment.
Main Methods:
- Prospective enrollment of pediatric patients with active EoE.
- 12-week induction therapy with PVB followed by a 12-week maintenance therapy at half the induction dose.
- Clinical, endoscopic, and histological assessments at baseline, week 12, week 24, and week 36.
- Serum cortisol levels were monitored throughout the treatment period.
Main Results:
- 90% of patients achieved remission after 12 weeks of induction therapy.
- 85% of patients maintained remission at week 24 (end of maintenance therapy).
- Remission rates decreased to 45% by week 36, after treatment suspension. No significant changes in cortisol levels were observed.
Conclusions:
- A 12-week maintenance therapy with half the induction dose of PVB effectively sustained remission in pediatric EoE patients up to 24 weeks.
- The study did not demonstrate a reduction in relapse rates after PVB treatment suspension.
- Further research is needed to optimize long-term management strategies for pediatric EoE.
Background:
A new prepared oral viscous budesonide (PVB) has been effective in inducing clinical and histological remission in pediatric eosinophilic esophagitis (EoE).
Aims:
To evaluate the efficacy of a 12-week maintenance therapy on clinical, endoscopic, and histological remission using half of the dose used in the induction therapy.
Methods:
We prospectively enrolled pediatric patients with active EoE. After 12 weeks of induction therapy with PVB (< 150 cm: 2 mg/day; ≥ 150 cm: 4 mg/day) patients received a maintenance dose of half of the dose used in the induction therapy (1 mg or 2 mg) for another 12 weeks. A 12-week follow-up was then performed in all patients after the end of therapy. Endoscopy was performed at weeks 0, 12, 24, and 36. Symptoms, endoscopy, and histology scores were also calculated. Serum cortisol was evaluated during the treatment period.
Results:
We enrolled 20 children (15 males; median age 10 years; range 4-17). After the 12-week induction therapy 18 patients (90%) were in remission, with a significant decrease in the median peak of eosinophil count/HPF as well as a marked reduction in clinical, endoscopic, and histological scores (p < 0.01). At the end of the maintenance therapy (week 24), 17 patients (85%) were still in remission, while there were only 9 at week 36 (45%). No significant changes in cortisol levels were observed during the study period.
Conclusions:
The 12-week maintenance treatment with the half the dose of PVB was effective in sustaining remission at week 24; however, no reduction in the rate of relapse after suspension of treatment occurred.
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