Long-Term Budesonide Oral Suspension Data in EoE

This episode, titled ‘Long-Term Budesonide Oral Suspension Data in EoE,’ features panelists examining findings from a long-term open-label extension study of budesonide oral suspension (BOS) and their relevance to clinical practice. The expert faculty discuss how the study allowed dose reductions and temporary treatment interruptions over 4 years, reflecting some of the challenges clinicians encounter when managing a chronic disease in which adherence may be affected by medication access, travel, lifestyle, or changes in treatment needs.

The panelists review the durability of response observed with long-term BOS treatment, including maintenance of histologic and endoscopic improvements in many patients despite permitted changes or interruptions in therapy. They discuss how these findings can help inform conversations with patients who have questions about remaining on treatment over time and reinforce the importance of continued monitoring, particularly because symptoms alone may not reliably indicate ongoing disease activity.

The expert faculty also examine the long-term safety and tolerability findings. Although treatment-emergent adverse events were reported during the study, the panel emphasizes the importance of considering their severity and relationship to treatment when interpreting the results. They also discuss adverse events of clinical interest with swallowed corticosteroid therapy, including esophageal candidiasis and adrenal axis suppression.

Finally, the panel considers limitations inherent to long-term extension studies, including the potential for patients who do not respond to or tolerate treatment to discontinue before completing extended follow-up. Overall, the discussion highlights how longer-term evidence can help clinicians contextualize the durability, safety, and practical use of BOS when counseling patients with EoE.

In the next episode, ‘Evolving Biologic Evidence in EoE,’ panelists will examine findings from the REMODEL and EoE KIDS trials and their potential implications for biologic therapy. The expert faculty discuss esophageal distensibility, fibrostenotic disease, pediatric outcomes, and how emerging evidence can inform treatment decisions and patient counseling.