Journal
DIGESTIVE DISEASES AND SCIENCES
Volume 56, Issue 12, Pages 3551-3558Publisher
SPRINGER
DOI: 10.1007/s10620-011-1775-y
Keywords
Eosinophilic esophagitis; Allergic esophagitis; Montelukast; Anti-leukotriene; Leukotriene D4; Dysphagia
Categories
Funding
- Castilla-La Mancha Health Research Foundation (Fundacion para la Investigacion Sanitaria de Castilla-La Mancha or FISCAM) [AN-2008/21]
Ask authors/readers for more resources
Background and Aims 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. Methods Eleven consecutively diagnosed adult EoE patients were prospectively studied. Esophageal biopsies were obtained before and after a 6-month treatment with fluticasone propionate 400 mu g/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. Results 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. Conclusions Montelukast was not efficient in maintaining the histopathological or clinical response achieved by topical steroids in adult EoE patients.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available