Am J Gastroenterol

Esophageal-targeted budesonide effective in EoE treatment switch

April 16, 2025

Study details: This study analyzed data from the Swiss Eosinophilic Esophagitis (EoE) Cohort Study, including 340 patients treated with budesonide orodispersible tablets (BOT) between 2015 and 2023. Patients were categorized based on their response to prior off-label swallowed topical corticosteroids (olSTC): non-responders, responders, and STC-naïve.

Results: Among the patients, 26% had prior olSTC non-response, 16% were in remission with olSTC, and 58% were STC-naïve. Multivariable logistic regression identified longer olSTC treatment duration, low adherence (<80%), and age <30 years as factors associated with olSTC non-response. Histologic remission rates with BOT were 77.3% in prior olSTC responders and 62.1% in non-responders (p=0.095). Combined remission rates were 61.4% in responders and 42.4% in non-responders (p=0.052).

Clinical impact: The findings suggest that most patients who don’t respond to olSTC aren't truly corticosteroid-refractory and can achieve remission with an esophageal-targeted budesonide formulation. BOT may be considered for patients with EoE who fail to respond to off-label STC treatments, particularly in younger patients and those with longer treatment durations or low adherence.

Source:

Murray FR, et al. (2025, March 31). Am J Gastroenterol. Loss of response to off-label swallowed topical corticosteroids in eosinophilic esophagitis can be overcome by a switch to an esophageal-targeted budesonide formulation. https://pubmed.ncbi.nlm.nih.gov/40162678/