Efficacy of a Second PPI Course After Steroid-Induced Remission in Eosinophilic Esophagitis Refractory to Initial PPI Therapy

INTRODUCTION: Eosinophilic esophagitis (EoE) requires maintenance therapy to avoid recurrence. We investigated the efficacy of a second course of proton pump inhibitors (scPPIs) to maintain steroid-induced histological remission (HR) in patients with EoE who had previously failed induction of remission with PPIs. METHODS: We retrospectively included 18 patients who achieved HR with topical steroids but could not be maintained on long-term topical steroids. Treatment outcomes were assessed after 12 weeks of scPPIs. RESULTS: Most of the patients (67%) maintained HR with high-dose PPI monotherapy at week 12. DISCUSSION: scPPIs might work as a maintenance strategy in primary PPI nonresponder EoE patients.