Dysphagia and Quality of Life May Improve with Mometasone Treatment in Patients with Eosinophilic Esophagitis

Abstract

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 µg 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. Posttreatment, 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.