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Z Gastroenterol 2021; 59(08): 869-878
DOI: 10.1055/a-1429-4192
Übersicht

Therapie der eosinophilen Ösophagitis – Fortschritte und Perspektiven

Treatment of eosinophilic esophagitis – advancements and perspectives
Stephan Miehlke
1   Magen-Darm-Zentrum, Facharztzentrum Eppendorf, Hamburg
2   Speiseröhrenzentrum Universitätsklinikum Hamburg-Eppendorf, Hamburg
,
Ulrike von Arnim
3   Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Magdeburg
,
Christoph Schlag
4   Medizinische Klinik II, Klinikum Rechts der Isar, Technische Universität, München
,
Joachim Labenz
5   Klinik für Innere Medizin, Diakonie Klinikum Jung-Stilling, Siegen
,
Ahmed Madisch
6   Klinik für Gastroenterologie, KRH Klinikum Siloah, Hannover
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Zusammenfassung

In jüngster Zeit wurden in der Therapie der eosinophilen Ösophagitis (EoE) und insbesondere im Bereich der topischen Corticosteroide erhebliche Fortschritte erreicht. Neue EoE-spezifische Darreichungsformen wurden entwickelt und haben in Form der orodispersiblen Budesonid-Tablette zu der ersten in Deutschland und anderen europäischen und außereuropäischen Ländern zugelassenen Therapie der EoE bei Erwachsenen geführt. In den USA steht eine EoE-spezifische orale Budesonid-Suspension kurz vor der Zulassung. Dagegen bleibt die wissenschaftliche Datenlage zur Wirksamkeit von Protonenpumpeninhibtoren weiterhin limitiert. Auch im Bereich der Biologika konnten nach langer Zeit Substanzen identifiziert werden, die erstmals in Phase 2 sehr vielversprechende Ergebnisse gezeigt haben und sich derzeit in klinischen Prüfungen der Phase 3 befinden. In diesem Artikel sollen die aktuellen Fortschritte und Perspektiven in der Therapie der EoE dargestellt und diskutiert werden.

Abstract

In recent years significant progress has been made in the treatment of eosinophilic esophagitis (EoE), especially in the area of topical corticosteroids. Novel EoE-specific formulations have been developed and first approvals have been obtained for induction and maintenance of remission in adult EoE patients with the orodispersible budesonide tablet in Germany and other European and non-EU countries. A novel budesonide oral suspension is currently under priority review by the FDA for first approval in the U.S. In contrast, the scientific evidence on the efficacy of proton pump inhibitors remains limited. Moreover, new biologicals have been identified which showed promising results in phase 2 trials and are now being studied in phase 3. This article aims to summarize and discuss recent advances and perspectives in the treatment of EoE.

Schlüsselwörter

Eosinophile Ösophagitis - topische Corticosteroide - Budesonid - Fluticason - Protonpumpeninhibitoren - Eliminationsdiät - Biologika

Key words

eosinophilic esophagitis - topical corticosteroids - budesonide - fluticasone - proton pump inhibitor - elimination diet - biological


Publication History

Received: 07 February 2021

Accepted: 07 March 2021

Article published online:
22 June 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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