Long-Term Budesonide Oral Suspension Therapy in EoE

This episode, titled ‘Long-Term Budesonide Oral Suspension Therapy in EoE,’ features panelists reviewing extended data with budesonide oral suspension and discussing what the findings may mean for long-term management. The experts describe outcomes from a study extending to 48 months, including histologic response using both stringent and conventional eosinophil thresholds and sustained improvement in EoE Endoscopic Reference Score.

The panel also discusses the practical reality of long-term swallowed corticosteroid use. Some patients in the study underwent dose reductions, while most maintained their dose. Faculty stress that prescribed dosing and actual patient use are not always identical, particularly with a treatment that may require twice-daily administration. They describe documenting what patients are actually taking rather than assuming perfect adherence from the prescription alone.

Safety and tolerability are also reviewed. Treatment-emergent adverse events occurred in many participants, although most were not considered related to therapy. Esophageal candidiasis is highlighted as an important but generally treatable adverse event, with recurrent candidiasis occasionally limiting continued therapy. Overall, the panel interprets the extension findings as evidence that a substantial proportion of patients can achieve and maintain histologic and endoscopic response over the long term with swallowed budesonide therapy.

In the next episode, ‘Individualizing EoE Treatment Across the Age Spectrum,’ panelists will examine how efficacy, safety, treatment feasibility, patient preferences, and pediatric evidence inform shared decision-making.