caa a22 4500 445794623 CHVBK 20180317145120.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s10620-011-1775-y doi (NATIONALLICENCE)springer-10.1007/s10620-011-1775-y Montelukast Was Inefficient in Maintaining Steroid-Induced Remission in Adult Eosinophilic Esophagitis [Elektronische Daten] [Alfredo Lucendo, Livia De Rezende, Susana Jiménez-Contreras, Jose Yagüe-Compadre, Jesús González-Cervera, Teresa Mota-Huertas, Danila Guagnozzi, Teresa Angueira, Sonia González-Castillo, Ángel Arias] Background and Aims: Leukotriene D4 is produced by and functions as a chemotactic factor for eosinophils. Eosinophilic esophagitis (EoE) is characterized by esophageal eosinophilic infiltration, determining structural changes and dismotility symptoms. Montelukast, a selective leukotriene D4 receptor antagonist, has gained increasing consideration as a therapeutic agent for EoE. However, limited available information has shown that montelukast is not effective in reducing eosinophilic infiltration. Our paper aims at evaluating whether montelukast could be consider as a steroid-sparing therapy by assessing its efficacy in maintaining both clinical and histopathological remission achieved after topical corticosteroids in adult EoE patients. Methods: Eleven consecutively diagnosed adult EoE patients were prospectively studied. Esophageal biopsies were obtained before and after a 6-month treatment with fluticasone propionate 400μg/twice a day. Immediately after that, montelukast 10mg/day was instituted. A new endoscopy was foreseen after a new 3-month period, or as soon as the patients presented esophageal symptoms. Symptoms were assessed by using a questionnaire before and after fluticasone propionate treatment and after montelukast therapy. Results: Eosinophils density into the esophageal epithelium and lamina propria was significantly reduced after a 6-month treatment with topical steroids (P = 0.003) and increased to levels similar to baseline level into the first 3months after treatment with montelukast. Baseline symptom scores significantly decreased after treatment with topical steroids (P = 0.003) and increased again after montelukast therapy, but baseline levels improved. Conclusions: Montelukast was not efficient in maintaining the histopathological or clinical response achieved by topical steroids in adult EoE patients. Springer Science+Business Media, LLC, 2011 Eosinophilic esophagitis nationallicence Allergic esophagitis nationallicence Montelukast nationallicence Anti-leukotriene nationallicence Leukotriene D4 nationallicence Dysphagia nationallicence Lucendo Alfredo Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700, Tomelloso, Ciudad Real, Spain aut De Rezende Livia Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700, Tomelloso, Ciudad Real, Spain aut Jiménez-Contreras Susana Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700, Tomelloso, Ciudad Real, Spain aut Yagüe-Compadre Jose Department of Pathology, Complejo Hospitalario La Mancha Centro, Alcázar de San Juan, Ciudad Real, Spain aut González-Cervera Jesús Department of Allergy, Hospital General de Tomelloso, Tomelloso, Ciudad Real, Spain aut Mota-Huertas Teresa Department of Pathology, Complejo Hospitalario La Mancha Centro, Alcázar de San Juan, Ciudad Real, Spain aut Guagnozzi Danila Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700, Tomelloso, Ciudad Real, Spain aut Angueira Teresa Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700, Tomelloso, Ciudad Real, Spain aut González-Castillo Sonia Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700, Tomelloso, Ciudad Real, Spain aut Arias Ángel Research Unit, Complejo Hospitalario La Mancha Centro, Alcázar de San Juan, Ciudad Real, Spain aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/12(2011-12-01), 3551-3558 0163-2116 56:12<3551 2011 56 10620 https://doi.org/10.1007/s10620-011-1775-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1775-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lucendo Alfredo Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700, Tomelloso, Ciudad Real, Spain aut NATIONALLICENCE 700 1- De Rezende Livia Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700, Tomelloso, Ciudad Real, Spain aut NATIONALLICENCE 700 1- Jiménez-Contreras Susana Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700, Tomelloso, Ciudad Real, Spain aut NATIONALLICENCE 700 1- Yagüe-Compadre Jose Department of Pathology, Complejo Hospitalario La Mancha Centro, Alcázar de San Juan, Ciudad Real, Spain aut NATIONALLICENCE 700 1- González-Cervera Jesús Department of Allergy, Hospital General de Tomelloso, Tomelloso, Ciudad Real, Spain aut NATIONALLICENCE 700 1- Mota-Huertas Teresa Department of Pathology, Complejo Hospitalario La Mancha Centro, Alcázar de San Juan, Ciudad Real, Spain aut NATIONALLICENCE 700 1- Guagnozzi Danila Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700, Tomelloso, Ciudad Real, Spain aut NATIONALLICENCE 700 1- Angueira Teresa Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700, Tomelloso, Ciudad Real, Spain aut NATIONALLICENCE 700 1- González-Castillo Sonia Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n, 13700, Tomelloso, Ciudad Real, Spain aut NATIONALLICENCE 700 1- Arias Ángel Research Unit, Complejo Hospitalario La Mancha Centro, Alcázar de San Juan, Ciudad Real, Spain aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/12(2011-12-01), 3551-3558 0163-2116 56:12<3551 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer