Dysphagia, Esophageal Stenosis, Recessive Dystrophic Epidermolysis Bullosa
Conditions
Brief summary
Budesonide is an anti-inflammatory medication that works by decreasing the immune system's overreaction. In the treatment of eosinophilic esophagitis, especially with Jorveza or a preparation made in a pharmacy, it reduces the production of substances responsible for inflammation in the esophagus. This action reduces the accumulation of certain inflammatory cells (eosinophils) and thus improves the symptoms and lesions of the esophagus. Dystrophic epidermolysis bullosa (EBD) is a rare genetic disease that makes the skin and mucous membranes very fragile. Blisters, sores and wounds can appear as a result of even minor trauma. Scarring is often abnormal and can cause tissue to shrink or shrink. To date, only two studies involving a total of eight children with EBD have evaluated a budesonide-based preparation. The results show an improvement in swallowing difficulties (dysphagia) as well as good tolerance of the treatment. However, there are currently no published data regarding the use of Jorveza in the form of an orally disintegrating tablet in adults with EBD. Through the follow-up of patients treated at the MAGEC reference center, specialized in rare genetic diseases of the skin and mucous membranes, we aim to evaluate the interest and effects of budesonide treatment in individuals with EBD presenting with dysphagia.
Detailed description
Budesonide is a non-halogenated glucocorticoid that has an anti-inflammatory effect by binding to glucocorticoid receptors. In the treatment of eosinophilic esophagitis, whether as Jorveza or as a compounded formulation, it inhibits the antigen-induced secretion of various cytokines and pro-inflammatory molecules such as thymic stromal lymphopoietin, interleukin-13, and eotaxin-3 in the esophageal epithelium (1). This action leads to a significant reduction in inflammatory eosinophil infiltrates in the esophagus. Dystrophic epidermolysis bullosa (DEB) is a rare genetic disease that causes fragile skin and mucous membranes, leading to blisters and wounds after trauma. Healing is abnormal and often associated with scarring and contractures. The literature only reports two pediatric studies, with a total of eight DEB patients treated with a compounded formulation (CF) budesonide-based. These studies have shown good tolerance and satisfactory effectiveness on dysphagia (2, 3). To date, there is no data on the use of Jorveza in orally disintegrating tablets in adults with EBD, even though it is recommended for this indication in official guidelines (4). Our goal is to evaluate, within a cohort followed at the MAGEC reference center, the usefulness of budesonide in PM/orally disintegrating tablets, in patients of all ages with EBD.
Interventions
OTHERThe retrospective data collected will be entered into an eCRF and then analyzed centrally
there is no treatment for the study but the patient take a treatment out of MMA and the retrospectives datas collected will be entered into an eCRF and then analyzed centrally by the sponsor
Sponsors
Centre Hospitalier Universitaire de Nice
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Retrospective study of a patient with recessive dystrophic epidermolysis bullosa and dysphagia treated with oral BUDESONIDE
Eligibility
Sex/Gender
ALL
Age
1 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients of both sexes, of any age, with EBD in dominant or recessive form, treated for at least one month with budesonide for dysphagia resistant to usual treatments. A description of the clinical form must be available in the file. The patient must assess the benefit of treatment at 1 and/or 3 months of Budesonide. Patients must be affiliated with social security. For adults, consent of non-opposition is required, and for minors, non-opposition from one of the parents or the person holding parental authority must be collected.
Exclusion criteria
No precise clinical or biological diagnosis. Treatment with Budesonide \< 1 month. No evaluation criteria in the file / Objection to the use of data (withdrawal of non-opposition)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| overall patient satisfaction with the treatment | month 1 | 5-point Likert scale (4: complete satisfaction and 0: no change) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The assessment of budesonide treatment tolerance in patients | Month 3 | Assessed based on the side effects and/or reasons for stopping the treatment recorded in the medical file. |
| Reduce meal time | Month 0 | yes or no |
| oesophagal expansion number | Month 0 | number of necessary expansions during the study |
Countries
France
Contacts
CONTACTChristine CHIAVERINI, Doctor
Outcome results
None listed