ArticleAnnals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology2026
Nasal and inhaled steroid use does not influence treatment response outcomes in eosinophilic esophagitis.
Article in Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEosinophilic esophagitis (EoE) guidelines suggest that nasal or inhaled steroids for rhinitis, sinusitis, or asthma may obscure the outcomes of EoE treatment. Few data support this assertion.
objectiveTo assess whether EoE treatment outcomes vary by nasal or inhaled steroid use or concomitant allergic rhinitis.
methodsWe conducted a retrospective cohort study of newly diagnosed patients with EoE treated with a topical corticosteroid, with follow-up endoscopy and biopsy. Extracted variables included a diagnosis of allergic rhinitis, treatment with nasal and/or inhaled steroids, and post-treatment symptoms, endoscopic data, and pathology results. Patients with and without treatment with nasal and/or inhaled steroids were compared. We also compared outcomes by diagnosis of allergic rhinitis and season at follow-up.
resultsOf the 473 patients, 185 (39%) had allergic rhinitis. Post-treatment symptom response (83% vs 77%; P = .37), EoE endoscopic reference score (1.9 ± 1.9 vs 2.3 ± 1.9; P = .07), and eosinophil counts (25.5 ± 41.8 vs 23.0 ± 32.4; P = .38) did not differ by allergic rhinitis status. No differences in histologic responses were found by nasal/inhaled steroid use (adjusted odds ratio for <15 eosinophil/high-power field: 0.96; 95% CI: 0.53-1.74) or in patients with asthma who were on inhaled steroids. Patients with allergic rhinitis had higher post-treatment eosinophil counts in the spring (41.3 ± 7.4 vs 20.5 ± 3.3 in other seasons; P = .01).
conclusionTreatment responses did not differ by nasal/inhaled steroid use or by concurrent allergic rhinitis. Patients with allergic rhinitis had a higher post-treatment eosinophil count in the spring. These data support the use of nasal/inhaled steroids in patients with EoE but suggest caution when assessing responses in the spring months.
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