Therapeutic Advances in Gastroenterology · Published 2026-07-01 · DOI 10.1177/17562848261465758
Jana Defrancq, Karlien Raymenants, Jan Tack, Tim Vanuytsel, Lucas Wauters
Background: Budesonide orodispersible tablets (BOT) are the first drug specifically developed for eosinophilic esophagitis (EoE), whereas budesonide viscous solution (BVS) is used off-label. Objectives: We aimed to assess the histological, endoscopic, clinical, and safety outcomes before and after switching maintenance therapy from BVS to BOT. Design: Observational cohort study of EoE patients who switched therapy from BVS to BOT at the same dose (1 mg) and dosing schedule (once daily (OD) or twice daily (BID)). Methods: We performed a retrospective analysis of a prospectively collected dataset. Routine procedures included endoscopy with biopsies to assess histological and endoscopic disease and whether candidiasis was present. Histological remission was defined as <15 eosinophils per high-power field (eos/HPF) and deep histological remission as <6 eos/HPF. Online questionnaires, including dysphagia symptom questionnaire (DSQ), eosinophilic esophagitis symptom activity index (EEsAI), numerical rating scale (NRS) for symptoms and adult eosinophilic esophagitis quality of life questionnaire (EoE-QoL-A), were filled out by patients to assess symptom severity and health-related quality of life (HRQoL). Data are presented as proportions or medians with interquartile ranges, using non-parametric paired tests for proportions or other variables. Results: In total, 45 patients were included. The majority of patients switched to BOT 1 mg OD ( n = 32, 25 males, age 35 (27.8–40.3) years and body mass index 24.3 (21.4–27.5) kg/m²). Endoscopy and questionnaires were repeated 170 (145.3–182) days after switch. The proportion of patients achieving histological ( p = 0.04) and deep histological ( p = 0.01) remission increased significantly. The total endoscopic reference score decreased significantly ( p = 0.003). Symptoms remained low (DSQ: p = 1; EEsAI: p = 0.9; NRS: p = 0.1), while a significant improvement in HRQoL (EoE-QoL-A: p = 0.008) was observed. A numeric increase in candidiasis was noted ( p = 0.3). Similar results were obtained for EoE patients switching maintenance therapy from BVS to BOT 1 mg BID. Conclusion: Maintenance therapy with BOT after BVS may be feasible and effective in the real-world management of EoE patients, with only a numeric increase in the endoscopic suspicion of candidiasis.
Abstract from DOAJ. Public domain (CC0 1.0).
Read the article at the publisher →
Defrancq, J., Raymenants, K., Tack, J., et al. (2026). Maintenance therapy with once or twice daily budesonide orodispersible tablets after budesonide viscous solution in eosinophilic esophagitis. Therapeutic Advances in Gastroenterology. https://doi.org/10.1177/17562848261465758