A multicenter research carried out by pediatricians from Spanish hospitals has evaluated the response to omeprazole (a proton pump inhibitor -or PPI – drug) in children with symptoms and histological findings compatible with EoE.
The authors prospectively recruited an overall of 56 patients with esophageal symptoms at two Pediatric Hospitals in Madrid between February 2013 and April 2015. After obtaining esophageal biopsies that confirmed a diagnosis of EoE, they were treated with omeprazole 1 mg/kg/day for a 8-week period. After that, endoscopy and biopsies were repeated, and patients with a positive response to the drug were maintained at same doses for an additional 1-year period.
After 8 weeks of treatment, histological response (defined as a drop down to less than 15 eos/high power field, was observed in 35 children (68.6%); 24 of them (47%) presented a complete response (less that 5 eos/hpf) and 11 (21.6%) a partial response (>5 and < 15 eos/hpf). Responder patients also reported a significant improvement of symptoms.
Notably, allergy test results, endoscopic features, and pH monitoring results did not predicte the response to omeprazole.
One year later, disease remission while on PPI treatment was maintained in 78.5% of the children that initially responded to omeprazole.
This research, that has been recently published in the Journal of Pediatric Gastroenterology and Nutrition, is the first one with a prospective fashion in demonstrating the efficacy of PPIs in most of children with EoE, in a similar way it happens in adults. PPIs are safe, cheap and convenient drugs that are efective in more than a half of EoE patients of all ages. Therefore, PPIs can be now consider as a first line therapy for patients with EoE, before considering dietary modifications and steroid-based treatment.