Table 1

Recommendations from the BSPGHAN EoE WG with voting consensus percentage

ThemeThe BSPGHAN EoE WG recommends that:Voting consensus (%)
1STS are indicated in:
 Induction therapy100
 Maintenance therapy100
 First-line treatment of EoE92
 Combination therapy with PPI83
 Second-line treatment after unsuccessful responses to dietary therapy and/or PPI100
 Oesophageal stricture treatment in isolation or as an adjunct to oesophageal balloon dilatation92
2 The type of STS preparation offered should take into consideration the child’s age, palatability, chance of adherence, comorbidities and family support100
 If a child is assessed to be able to tolerate and coordinate orodispersible budesonide (tablet) preparation and it is locally available, then this preparation should be first choice.92
3 Age should be used to determine STS dosing unless a child significantly deviates from their growth centiles, in which case height should be accounted for.100
4 Twice daily dosing is considered for induction therapy.100
 For children <10 years old, a dose of 0.5 mg two times per day should be used (1 mg/day), for children ≥10 years old, a dose of 1 mg two times per day should be used (2 mg/day).100
 Induction therapy should be usually given for a minimum of 3 months.100
5 After histological remission has been achieved, maintenance therapy should be considered for a minimum of 1–2 years.100
 For children <10 years old, a dose of 0.5 mg/day should be used, for children ≥10 years old, a dose of 1 mg/day should be used.100
6 After confirmed histological remission and 3-month induction therapy, clinicians should consider halving the STS dose.100
 During maintenance therapy, dose weaning should be considered every 6–12 months.92
 Oral or oesophageal candidiasis does not usually require stopping the STS; antifungal treatment should be added alongside the STS.83
7Endoscopy
 Should be repeated during the induction period to ensure histological response to STS and allow weaning of the medication.92
 Should be repeated if there is worsening of symptoms/oesophageal dysfunction.100
 Surveillance should be considered at 1–2 yearly intervals or if considering stopping treatment or following cessation of therapy if clinically indicated.100
  • BSPGHAN EO WG, British Society of Paediatric Gastroenterology, Hepatology and Nutrition Eosinophilic Oesophagitis Working Group; PPI, proton pump inhibitor; STS, swallowed topical steroid.