Budesonide Suspensi Topikal sebagai Pilihan Terapi Esofagitis Eosinofilik

Oleh :

dr. Brenda Desy Romadhon

Budesonide suspensi, yang biasa digunakan pada terapi nebulizer untuk asma, dapat diberikan topikal untuk pengobatan esofagitis eosinofilik. Budesonide suspensi topikal adalah dengan membuat bubur oral viscous budesonide (OVB), sehingga saat ditelan zat budesonide dapat menempel langsung di dinding esofagus.

Walaupun pemberian budesonide suspensi oral tersebut off-label, tetapi terbukti dapat menurunkan jumlah hitung jenis eosinofil, memperbaiki gambaran endoskopi, hingga memperbaiki gejala esofagitis. Artikel ini adalah mempelajari efikasi pemberian steroid topikal, termasuk budesonide suspensi oral, dalam menginduksi remisi histologis dan klinis pada pasien esofagitis eosinofilik.[1,5-8]

Sumber: Openi, 2009

Esofagitis Eosinofilik

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. Murali AR, Gupta A, Attar BM, Ravi V, Koduru P. Topical steroids in eosinophilic esophagitis: Systematic review and meta-analysis of placebo-controlled randomized clinical trials. J Gastroenterol Hepatol. 2016 Jun;31(6):1111-9.
2. Jurnalis YD, Sayuti Y, Widiasteti. Eosinofilik Esofagitis. Jurnal Kesehatan Andalas. 2013; 2(2) : 183-188
3. D'Alessandro A, Esposito D, Pesce M, Cuomo R, De Palma GD, Sarnelli G. Eosinophilic esophagitis: From pathophysiology to treatment. World J Gastrointest Pathophysiol. 2015 Nov 15;6(4):150-8.
4. Roussel JM, Pandit S. Eosinophilic Esophagitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK459297/
5. Reed CC, Fan C, Koutlas N, Stefanadis Z, Eluri S, Shaheen NJ, Dellon ES. Compounded Oral Viscous Budesonide is Effective and Provides a Durable Response in Eosinophilic Esophagitis. HSOA J Gastroenterol Hepatol Res. 2018;7(1):2509-2515.
6. Rawla P, Sunkara T, Thandra KC, Gaduputi V. Efficacy and Safety of Budesonide in the Treatment of Eosinophilic Esophagitis: Updated Systematic Review and Meta-Analysis of Randomized and Non-Randomized Studies. Drugs R D. 2018;18(4):259–269
7. Dellon ES, Woosley JT, Arrington A, McGee SJ, Covington J, Moist SE, Gebhart JH, Tylicki AE, Shoyoye SO, Martin CF, Galanko JA, Baron JA, Shaheen NJ. Efficacy of Budesonide vs Fluticasone for Initial Treatment of Eosinophilic Esophagitis in a Randomized Controlled Trial. Gastroenterology. 2019 Jul;157(1):65-73.e5.
8. Dohil R, Newbury R, Fox L, Bastian J, Aceves S. Oral viscous budesonide is effective in children with eosinophilic esophagitis in a randomized, placebo-controlled trial. Gastroenterology. 2010 Aug;139(2):418-29.
9. Gupta SK, Vitanza JM, Collins MH. Efficacy and safety of oral budesonide suspension in pediatric patients with eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2015 Jan;13(1):66-76.e3.
10. Kang HR, Kwon YH, Kim YJ. A case of esophageal candidiasis in an adolescent who had frequently received budesonide nebulizing therapy. Pediatr Gastroenterol Hepatol Nutr. 2013 Sep;16(3):185-9.
11. Greuter T, Alexander JA, Straumann A, Katzka DA. Diagnostic and Therapeutic Long-term Management of Eosinophilic Esophagitis - Current Concepts and Perspectives for Steroid Use. Clin Transl Gastroenterol. 2018;9(12):e212.
12. Hsu S, Wood C, Pan Z, Rahat H, Zeitler P, Fleischer D, Menard-Katcher C, Furuta GT, Atkins D. Adrenal Insufficiency in Pediatric Eosinophilic Esophagitis Patients Treated with Swallowed Topical Steroids. Pediatr Allergy Immunol Pulmonol. 2017 Sep 1;30(3):135-140.
13. Albert D, Heifert TA, Min SB, Maydonovitch CL, Baker TP, Chen YJ, Moawad FJ. Comparisons of Fluticasone to Budesonide in the Treatment of Eosinophilic Esophagitis. Dig Dis Sci. 2016 Jul;61(7):1996-2001.
14. Loke YK, Cavallazzi R, Singh S. Risk of fractures with inhaled corticosteroids in COPD: systematic review and meta-analysis of randomised controlled trials and observational studies. Thorax. 2011 Aug;66(8):699-708.