Oral Cromolyn Sodium for the Treatment of Eosinophilic Esophagitis

Phase 4

Completed

Brief Summary: This is a randomized, double-blind, placebo-controlled study of oral cromolyn sodium when made into a viscous preparation for the treatment of eosinophilic esophagitis.

Detailed Description: Eosinophilic esophagitis is an antigen-mediated allergic disease of the esophagus characterized by symptoms of gastrointestinal complaints and eosinophilic inflammation limited to the esophagus. Currently, first line therapeutic recommendations include swallowed, topical steroids or dietary therapy. While both work for the majority of patients, they both have limitations.

The investigators are examining the use of oral cromolyn sodium as a treatment for this condition. This medication is a non-steroid that is already approved for other conditions. When taken orally, it is essentially not absorbed systemically, so side effects are minimal. There is only 1 brief, retrospective report of its use in this condition suggesting it does not work. However, from studying swallowed, topical steroids, it may require formulating the medication into a viscous preparation for it to work.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Concomitant treatment with swallowed corticosteroids. Any prior use of swallowed corticosteroids will require a 4 week washout period.
Pregnancy (all females of child bearing potential will have urine pregnancy test done at baseline).
Evidence of pathologic eosinophilia in other locations in the GI tract.
Participation in another research protocol
Reduced Renal or Hepatic Function (all subjects will have a baseline creatinine and liver function panel drawn)

Arm && Interventions

Group	Intervention	Description
Oral cromolyn	oral cromolyn sodium	Subjects randomized to the experimental arm will receive oral cromolyn sodium. The dose will be per current package insert for oral cromolyn: Subjects 2-12 years of age - 100 mg (1 ampule) 4 times daily Subjects 13-18 years of age - 200 mg (2 ampules) 4 times daily
Placebo	Placebo	Subjects randomized to placebo will receive normal saline ampules Subjects 2-12 years of age - 1 ampule 4 times daily Subjects 13-18 years of age - 2 ampules 4 times daily

Primary Outcome Measures

Name	Time	Method
Peak Esophageal Eosinophil Count	2 months	Measure of the peak esophageal eosinophil count on esophageal biopsy specimens after 2 months of therapy

Secondary Outcome Measures

Name	Time	Method
Symptoms as Measured by Pediatric Eosinophilic Esophagitis Symptom Score	Baseline as compared to 2 months	Symptom scores will be measures at baseline, 1 month, and 2 months using a symptom scoring assessment tool known as the Pediatric Eosinophilic Esophagitis Symptom Score (PEESS). The PEESS is a validated symptom score that is completed by the parent of the patient. It encompasses frequency and severity of EoE related symptoms over the past month. The minimum score = 0. The max score = 98 The higher the score/value, the more severe and/or frequent the symptoms and therefore a worse outcome.