Allergy drug found to clear condition but not symptoms of throat disease
2010-10-19
(Press-News.org) ROCHESTER, Minn. -- A group of Mayo Clinic (http://www.mayoclinic.org/about/) researchers conducted the first controlled trial of swallowed fluticasone nasal spray (also known as Flonase) on people with the allergic esophageal condition called eosinophilic esophagitis (http://www.mayoclinic.org/eosinophilic-esophagitis/). Research showed that the aerosolized swallowed allergy drug helped treat the cause of the throat condition, but symptoms lingered. The researchers' findings were presented today at the Annual Scientific Meeting of the American College of Gastroenterology (http://www.acg.gi.org/) in San Antonio.
Eosinophilic esophagitis is a relatively new disease, first noticed in young people, that causes those who have the condition to feel like solid food is sticking in their throat or like they have heartburn. A steroid applied to the esophagus is often used for treatment, but its effectiveness has not been scientifically proven.
For the randomized, double-blind study, 34 adults swallowed either a placebo or aerosolized fluticasone twice a day for six weeks. Fluticasone is used in inhalers and as a nasal spray to treat inflammation in the lungs and sinuses caused by allergies. The drug is a corticosteroid that decreases irritation and swelling and, when used for asthma, allows for easier breathing.
After completing the course of medication, the research volunteers were given questionnaires to assess their symptoms and side effects of the treatment. Their throats were examined with an endoscope and then through biopsies for the presence of eosinophils -- a type of white blood cell that secretes proteins, which researchers suspect causes swallowing problems.
"We had complete histologic remission in 68 percent of the people who took the fluticasone, compared to zero for the placebo," says Jeffrey Alexander, M.D., (http://www.mayoclinic.org/bio/13216619.html) a Mayo Clinic gastroenterologist and lead author on the study. "From this perspective, fluticasone does get rid of the eosinophils in the esophagus; however, people's symptoms did not improve."
Dr. Alexander attributes the lack of symptom improvement to several confounding factors. "We had a symptom response in 63 percent of the people, but we had a placebo response in
47 percent of the people, which is very high," Dr. Alexander says. "Our experience in clinical practice is that the symptoms do get better. We suspect the lack of symptom response was related to difficulty in assessing intermittent swallowing symptoms with our questionnaire."
The research team has multiple ongoing studies in the diagnosis, pathophysiology and treatment of eosinophilic esophagitis.
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The research project was funded by the Fitterman Grant to the Mayo Division of Gastroenterology (http://www.mayoclinic.org/gi/). Mayo Clinic co-authors include Kevin Jung; Amindra Arora, M.B., B. Chir; Felicity Enders, Ph.D.; Dawn Francis, M.D.; Hirohita Kita, M.D.; Yvonne Romero, M.D.; David Katzka, M.D.; Thomas Smyrk, M.D.; and Nicholas Talley, M.D.
About Mayo Clinic
For more than 100 years, millions of people from all walks of life have found answers at Mayo Clinic. These patients tell us they leave Mayo Clinic with peace of mind knowing they received care from the world's leading experts. Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. At Mayo Clinic, a team of specialists is assembled to take the time to listen, understand and care for patients' health issues and concerns. These teams draw from more than 3,700 physicians and scientists and 50,100 allied staff that work at Mayo Clinic's campuses in Minnesota, Florida, and Arizona; and community-based providers in more than 70 locations in southern Minnesota., western Wisconsin and northeast Iowa. These locations treat more than half a million people each year . To best serve patients, Mayo Clinic works with many insurance companies, does not require a physician referral in most cases and is an in-network provider for millions of people. To obtain the latest news releases from Mayo Clinic, go to www.mayoclinic.org/news. For information about research and education visit www.mayo.edu. MayoClinic.com (www.mayoclinic.com) is available as a resource for your general health information.
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[Press-News.org] Allergy drug found to clear condition but not symptoms of throat disease
