TOPLINE:

Coexisting allergic rhinitis (AR) and concurrent use of intranasal and/or inhaled corticosteroids did not affect histologic response to topical corticosteroids in patients with eosinophilic esophagitis (EoE). However, patients with AR assessed in spring had higher posttreatment eosinophil counts than those assessed in other seasons.

METHODOLOGY:

• Researchers conducted a retrospective cohort study to evaluate whether the presence of concomitant AR and concurrent non-esophageal corticosteroid use, whether nasal and/or inhaled, altered treatment outcomes in patients with EoE.
• They included 473 patients with newly diagnosed EoE (mean age, 29.0 years; 67% males) who received topical corticosteroids and completed a posttreatment endoscopy and biopsies.
• Patients had been previously treated with either oral viscous budesonide (1-2 mg/d) or fluticasone from a multidose inhaler (440-1760 µg/d), with a repeat endoscopy performed after an 8- to 12-week treatment course.
• Baseline and posttreatment endoscopic findings, assessed as EoE Endoscopic Reference Score, and histologic findings, assessed as peak eosinophils per high-power field (eos/hpf), were compared.
• Researchers also compared the likelihood of achieving a histologic response to swallowed steroids between patients who had received inhaled and/or intranasal corticosteroids and those who had not used these medications before follow-up.

TAKEAWAY:

• Overall, 39% of patients had AR, making it the most prevalent atopic condition.
• Posttreatment symptom response, total EoE Endoscopic Reference Score, peak eosinophil counts, and probability of histologic response did not differ by AR status.
• The concurrent use of intranasal and/or inhaled corticosteroids did not affect histologic response at thresholds of < 15, ≤ 6, or < 1 eos/hpf, and this finding persisted when the cohort was stratified by AR status.
• Among patients with AR, those who had follow-up endoscopy in spring had significantly higher posttreatment mean eosinophil counts than those who had it in other seasons (P = .04). 

IN PRACTICE:

“As opposed to current guidance advising the discontinuation of intranasal and/or inhaled corticosteroids while assessing EoE-related outcomes, our data suggest that this recommendation may not be necessary,” the authors of the study wrote. “These data support that intranasal and/or inhaled corticosteroids should not be withheld during assessment of EoE-related disease activity,” they added.

SOURCE:

Craig C. Reed, MD, MSCR, with the University of North Carolina at Chapel Hill, was the corresponding author of the study, which was published online on June 06, 2026, in the Annals of Allergy, Asthma & Immunology.

LIMITATIONS:

The study had a retrospective design and relied on existing medical records. Diagnoses of AR were based on medical records, and specific aeroallergen data were often unavailable. Patient-reported outcomes were not commonly measured, and adherence to treatment was not strictly assessed.

DISCLOSURES:

This study was supported in part by a summer research grant for medical students, provided by the University of North Carolina Medical Student Summer Research Program. Two authors disclosed receiving research funds, consulting fees, or educational grants from multiple sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.