Children treated with proton pump inhibitors for eosinophilic esophagitis saw their symptoms improve significantly, though some continued to have inflammation, according to study results.
A study of 38 patients (30 boys) with an average age of 6.7±5.4 years was conducted to test the efficacy of proton pump inhibitors (PPIs) in children with eosinophilic esophagitis (EoE).
Children who had two or more endoscopies and a diagnosis of EoE were eligible for the study. Their endoscopic specimens needed to show >15 eosinophils per high-power field (HPF) at baseline. All patients had been previously treated with PPIs, but still displayed persistent eosinophilic inflammation.
Skin-prick tests for allergens were performed on 11 of the 38 children.
The patients were evaluated in two groups: those aged <5.1 years and those aged >5.1 years.
All patients received either lansoprazole (n=27) or omeprazole (n=11) PPI. The follow-up period for all patients was 3.0±2.4 years.
At the start of the study, dysphagia and vomiting were the most common EoE symptoms seen. Sixteen children presented with dysphagia (n=8, in the >5.1-years group; P<.05) or vomiting (n=8, in the <5.1-years group; P<.05).
The investigators said at follow-up, 26 patients were asymptomatic; 20 continued to present with eosinophilic inflammation and an endoscopic biopsy specimen displaying >15 eosinophils/HPF. The remaining 12 patients reported that their symptoms had significantly improved; eight children showed >15 eosinophils/HPF; the other four showed <15 eosinophils/HPF.
All patients’ standard scores (z scores) significantly improved. At baseline they were –0.143±1.1; at follow-up, they were 0.082±1.1 (P<.05).
“Longer follow-up is needed to determine whether persistent EoE in PPI-treated patients is associated with any long-term complications,” investigators concluded. “PPI treatment may be useful maintenance therapy in children with EoE.”