Dysphagia and quality of life may improve with mometasone treatment in patients with eosinophilic esophagitis: a pilot study.

OBJECTIVE: The treatment of adult patients with eosinophilic esophagitis remains challenging. The aim was to assess dysphagia and health-related quality of life (HRQL) using validated scales and questionnaires before and after treatment with mometasone furoate. STUDY
DESIGN: Case series with planned data collection.
SETTING: University hospital and secondary referral hospital. SUBJECTS AND METHODS: Newly diagnosed patients with eosinophilic esophagitis were included and given 200 µg of orally administered topical mometasone furoate 4 times daily. Questionnaires incorporating the Watson Dysphagia Scale (WDS), the European Organization for Research and Treatment of Cancer Quality of Life-Oesophageal Module 18 (EORTC QLQ-OES18), and the Short Form-36 (SF-36) were completed before the initiation of treatment and after 2 months of treatment.
RESULTS: Thirty-one consecutive patients (23 men; mean age, 45 years; range, 18-89 years) completed the trial. At inclusion, the mean scores of the WDS, the EORTC QLQ-OES18 dysphagia scale, the eating scale and choking item, and the global health and social functioning dimensions of the SF-36 were 21.3, 20.4, 35.0, 38.6, 71.1, and 82.3, respectively. Posttreatment, these scores improved to 8.9 (P < .0001), 4.6 (P < .00001), 17.8 (P < .001), 16.0 (P < .01), 76.1 (P < .05), and 91.9 (P = .0001), respectively. Except for 1 case of oral candidiasis, no significant side effects were reported.
CONCLUSION: The dysphagia and impaired HRQL found in untreated patients with eosinophilic esophagitis improved significantly after 2 months of mometasone furoate treatment. A randomized placebo-controlled trial is warranted to assess causality. The scales and questionnaires used are sensitive instruments appropriate for symptom surveillance in individuals with eosinophilic esophagitis.

RCT Entities:   Population Interventions Outcomes