Dysphagia and Quality of Life May Improve with Mometasone Treatment in Patients with Eosinophilic Esophagitis: A Pilot Study
Dysphagia and Quality of Life May Improve with Mometasone Treatment in Patients with Eosinophilic Esophagitis: A Pilot Study
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DOI：
10.1177/0194599811409857
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发表时间：
2011-10-01
影响因子：
3.4
通讯作者：
Bove, Mogens
中科院分区：
文献类型：
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作者：
Bergquist, Henrik;Larsson, Helen;Bove, Mogens
Objective.成人嗜酸性食管炎患者的治疗仍然具有挑战性。目的是评估吞咽困难和健康相关的生活质量（HRQL）使用验证量表和问卷治疗前后糠酸莫米松。计划数据收集的病例系列。设置。大学医院和二级转诊医院。对象和方法。入选新诊断的嗜酸性食管炎患者，给予200 μ g糠酸莫米松局部口服，每日4次。在治疗开始前和治疗2个月后完成包括沃森吞咽困难量表（WDS）、欧洲癌症研究和治疗组织生活质量-食管模块18（EORTC QLQ-OES 18）和简明健康调查表-36（SF-36）的问卷。31例连续患者（23例男性;平均年龄45岁;范围18-89岁）完成了试验。入选时，WDS、EORTC QLQ-OES 18吞咽困难量表、进食量表和窒息项目以及SF-36的总体健康和社会功能维度的平均评分分别为21.3、20.4、35.0、38.6、71.1和82.3。治疗后，这些评分分别提高至8.9（P < .0001）、4.6（P < .00001）、17.8（P < .001）、16.0（P < .01）、76.1（P < .05）和91.9（P = .0001）。除1例发生口腔念珠菌感染外，无明显不良反应。糠酸莫米松治疗2个月后，未治疗的嗜酸性食管炎患者的吞咽困难和HRQL受损明显改善。需要进行随机安慰剂对照试验来评估因果关系。量表和问卷调查是敏感的工具，适用于嗜酸性粒细胞性食管炎患者的症状监测。
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 mu g 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. Post-treatment, 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.