What Is the Maintenance Treatment of Eosinophilic Gastritis?
Eosinophilic gastritis is a chronic inflammatory condition of the gastric mucosa requiring long-term management. Sustaining disease control while minimising cumulative treatment burden is a central clinical challenge.
Treatment Approach
Maintenance regimens centre on an oral, locally-acting corticosteroid with a favourable systemic tolerability profile. When this approach is insufficient or not appropriate, steroid-sparing agents from several different drug classes are available as alternatives — the complete protocol defines the options, their indications, and how concomitant upper GI involvement is handled.
References
DOI: 10.3390/ijms242015165
- Accordingly, budesonide (locally effective and with lower systemic adverse events), elimination dietary regimens, and steroid-sparing drugs (including leukotriene inhibitors, azathioprine, antihistamines, and mast-cell stabilizers) have been proposed as alternatives.
- Other steroid-sparing agents, such as the leukotriene antagonist montelukast, have shown beneficial results in patients with EoGE, including those with steroid-dependent EoGE.
- Mast cell membrane stabilizers, such as sodium cromoglycate, and antihistaminic drugs, like ketotifen, have also been used in the treatment of EoGE alone or in combination with steroids, although with inconsistent results.
- Finally, PPI treatment may be useful in patients with concomitant EoE and EoN with duodenal involvement.
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