{
  "abstract": "Eosinophilic Oesophagitis (EO) is a chronic, antigen/immune-mediated disease of the oesophagus. First-line treatments include proton pump inhibitors (PPIs), elimination diets, and topical swallowed corticosteroids (TSC). Budesonide orodispersible tablets (BOT) have demonstrated efficacy in adult EO patients in recent randomized trials, 1 2 although their use remains off-label in individuals under 18 years of age. This study aimed to assess the real-world efficacy and safety of BOT in a paediatric cohort with EO refractory to standard therapies.We conducted a retrospective analysis of electronic medical records from children with EO followed at our Centre through July 2025. Primary outcomes included clinical remission (absence of EO-related symptoms), endoscopic remission (Endoscopic Reference Score for EO [EREFS] = 0), and histological remission (<15 eosinophils/high-power field).Seventeen children were treated with BOT 0.5 mg twice daily, initiated after a median of 16 months from diagnosis (IQR: 11–28.5). Prior therapies included PPIs (17/17, 100%), coupled with elimination diets (4/17, 24%), or TSC (4/17, 24%). All patients underwent a baseline endoscopy before BOT initiation, showing a median EREFS of 3 (IQR: 2–3). BOT was administered alongside PPI therapy in 11/17 (65%) patients. After 3 months, clinical remission was achieved in 11/17 (65%) children. Concomitant PPI therapy was not significantly associated with clinical remission [OR 0.87 (0.11-7.1 CI 95%), p=1]. Eight patients underwent repeat endoscopy after a median of 11.5 months (IQR: 6.75–16.75); 6/8 (75%) were in endoscopic remission, and 7/8 (87.5%) achieved histological remission. Eosinophil counts significantly decreased from baseline [median 30 (IQR: 15–50) to 6 (IQR: 6–9); p = 0.03]. Among the four patients who had previously failed TSC therapy, three achieved clinical, endoscopic, and histological remission. After a median follow-up of 12.5 months (IQR: 6.25–21), 11/17 (64.7%) remained on BOT therapy (figure 1), and 9/11 (82%) were in clinical remission. No adverse events were reported.BOT was a safe and effective treatment option for EO in patients who had not responded to previous standard therapies, including off-label TSC.References Straumann A, Lucendo AJ, Miehlke S, et al. Budesonide orodispersible tablets maintain remission in a randomized, placebo-controlled trial of patients with eosinophilic esophagitis. Gastroenterology 2020;159(5):1672–85.e5.Lucendo AJ, Miehlke S, Schlag C, et al. International EOS-1 study group. Efficacy of budesonide orodispersible tablets as induction therapy for eosinophilic esophagitis in a randomized placebo-controlled trial. Gastroenterology 2019 Jul;157(1):74-86.e15.Abstract OC59 Figure 1Budesonide orodispersible tablets (BOT) durability in a paediatric EO cohort",
  "authors": [
    {
      "affiliations": [
        "Department of Paediatric Gastroenterology, Hepatology and Nutrition, Royal Hospital for Children & Young People, Edinburgh, UK"
      ],
      "name": "Saverio Pochesci"
    },
    {
      "affiliations": [
        "Amsterdam UMC, Amsterdam, Netherlands"
      ],
      "name": "Camilo Maza Angulo"
    },
    {
      "affiliations": [
        "Department of Paediatric Gastroenterology, Hepatology and Nutrition, Royal Hospital for Children & Young People, Edinburgh, UK"
      ],
      "name": "Heather Grant"
    },
    {
      "affiliations": [
        "Department of Paediatric Gastroenterology, Hepatology and Nutrition, Royal Hospital for Children & Young People, Edinburgh, UK"
      ],
      "name": "Richard Russell"
    }
  ],
  "title": "OC59 Real-world effectiveness of budesonide orodispersible tablets in paediatric eosinophilic oesophagitis",
  "uid": "d21620cc-a232-505e-9082-0b5a593e1ee3"
}