Effects of Swallowed Corticosteroids on Bone Mineral Density and Growth Velocity in Children With Eosinophilic Esophagitis
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Effects of swallowed corticosteroids on bone mineral density
研究概览
简要总结
Eosinophilic esophagitis (EoE) is characterized by allergy-driven inflammation of the esophagus leading to a variety of gastrointestinal symptoms and increased healthcare utilization. While considered a rare disease, EoE is rapidly increasing in prevalence in the United States. Treatment options are limited and include dietary modifications with the elimination of suspected food triggers or pharmacological options including proton pump inhibitors (PPIs) and swallowed corticosteroids. Compliance to strict elimination diets is difficult thus many patients elect to use swallowed corticosteroids. Because nearly half of all EoE patients are treated with swallowed corticosteroids there is a growing concern regarding the long-term effects of this class of medication.4
It is known that oral corticosteroids can compromise bone mineral density and growth velocity5-7. Furthermore, there have been multiple studies exploring the relationship between inhaled corticosteroids (ICS) and endocrine effects in asthmatics. While the risk of ICS use is less compared to systemic corticosteroids, higher ICS doses do cause deleterious effects on growth and bone health8-11. Currently, there are no published studies examining the effect of swallowed corticosteroids on bone mineral density or growth velocity in patients with EoE. Given the route of administration, there may be more systemic absorption leading to a higher risk of long-term complications.
The proposed work will address the following specific aims:
Specific Aim 1: Assess effects of swallowed corticosteroids on bone mineral density (primary outcome) in children 5-12 years of age with EoE compared to age matched controls.
Specific Aim 2: Evaluation of the effect of swallowed corticosteroids on growth velocity.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 年龄范围
- 5 Years 至 12 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Intervention:
- •Age 5-12 years
- •Diagnosis of EoE based upon a peak eosinophil count of ≥ 15 eosinophils/high powered field (hpf) on at least one esophageal biopsy while on a minimum of 8 weeks of PPI therapy
- •Patient/Family has elected to start swallowed corticosteroids for the treatment of EoE with a minimum daily dose of at least 0.5 mg budesonide or 440 mcg fluticasone. The decision to start swallowed corticosteroids will be made based upon the judgement of the provider, potential subject, and family during a clinic visit and will not be part of the research procedures.
- •Controls:
- •Age 5-12 years
- •Followed in the ACH allergy clinic, but not required to have a diagnosis of EoE
- •Not treated with swallowed corticosteroids
排除标准
- •Intervention and controls:
- •Non-English speaking
- •Patients actively taking systemic corticosteroids or previous use of systemic corticosteroids within the past 6 months
- •Patients actively taking inhaled corticosteroids or prior use of inhaled corticosteroids in the 6 months prior to screening
- •Current or previous treatment with swallowed corticosteroids for EoE at the time of screening
- •Osteopenia or osteoporosis on baseline dual energy X-ray absorptiometry (DEXA).
结局指标
主要结局
Effects of swallowed corticosteroids on bone mineral density
时间窗: 12 months
Change in bone mineral density over 1 year while being treated with swallowed corticosteroids compared to age-matched controls
次要结局
- Effects of swallowed corticosteroids on linear growth(12 months)