Gutiérrez-Junquera C, et al. - In this prospective study, researchers assessed the long-term effectiveness and safety of proton pump inhibitors (PPIs) in children with eosinophilic esophagitis (EoE). Data revealed that up to 70% of children with PPI-responsive EoE sustain histological and clinical remission on low-dose maintenance treatment at 1-year follow-up, with an acceptable safety profile. Complete histological remission to an 8-week PPI trial correlated with higher probability of histological remission on maintenance therapy.

Methods

• Participants in the study were children with EoE and histological remission to an 8-week esomeprazole trial (1 mg/kg/dose, twice daily).
• For 1 year, esomeprazole was maintained at 1 mg/kg/day.
• Symptom recurrence and adverse events were monitored, with a follow-up endoscopy performed at 12 months.
• Complete histological remission was characterized as ≤ 5 eosinophils/high-power field (eos/hpf), and partial histological remission as > 5 and < 15 eos/hpf.
• Subjects had no concomitant dietary restrictions or topical steroid.

Results

• In this analysis, 57 children were involved.
• It was observed that histological remission on maintenance PPI therapy was seen in 40 children (70.1%; 95% CI 56.5–81.5).
• Compared to children with partial remission (81% vs 50%, P=0.014), children with initial complete histological remission had a higher long-term remission rate.
• It was noted that 49 children (86%) remained asymptomatic.
• Findings revealed that pretreatment clinical and histological findings and median PPI dose/kg/day were similar between relapsers and nonrelapsers.
• In 5 children, mild and transient side effects were found, but PPI avoidance was not needed.