{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T08:17:49Z","timestamp":1773130669379,"version":"3.50.1"},"reference-count":23,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Inflamm Intest Dis"],"abstract":"<jats:p>Introduction: Lymphocytic esophagitis (LyE) represents a chronic inflammatory disease of the esophagus with low response rates to topical steroids. Thus, novel treatment options such as swallowed topical tacrolimus, particularly for refractory cases, are urgently needed. Methods: We retrospectively analyzed patients with LyE enrolled in the Swiss eosinophilic esophagitis database that received treatment with a swallowed tacrolimus syrup (1 mg bid). We compared clinical (visual analogue scale [VAS] 0\u201310), endoscopic (VAS, Endoscopic Reference Score [EREFS]), and histological (peak lymphocyte count) disease activity before versus after treatment. Results: Out of 17 LyE patients, we identified a total of 7 patients undergoing tacrolimus treatment (4 males, median age 71.3 years, IQR: 61.3\u201376.5, median diagnostic delay of 51.0 months, IQR: 24.5\u201362.0). Six patients had been previously treated with PPI, five with topical and\/or systemic steroids. All patients were treated with topical tacrolimus corresponding to 1 mg bid (for a median of 13 weeks, IQR: 11\u201315). All patients had clinically, and histologically active disease at baseline. Topical tacrolimus treatment resulted in histological remission (&lt;30 lymphocytes\/hpf) in 3\/7 patients (42.9%), while 4\/7 patients achieved symptomatic remission (VAS for dysphagia \u22642, 57.1%). Overall, clinical (VAS 5 vs. 2, p = 0.0625) and endoscopic activity (VAS 5 vs. 2, p = 0.0625, and EREFS 3 vs. 2, p = 0.125) decreased. Measurement of tacrolimus trough levels in 4\/7 patients (range 2.1\u20133.9 \u03bcg\/L) revealed some degree of systemic absorption. Mild adverse events to the tacrolimus treatment were seen in 2 patients (esophageal candidiasis, hyposensitivity around lips). No impact on kidney function was observed during the treatment period. Conclusion: Topical tacrolimus appears to be a potential treatment option for severe LyE, particularly after failure of PPI and\/or topical steroids. Further studies are needed, in particular regarding the optimal galenic formulation to avoid systemic absorption. <\/jats:p>","DOI":"10.1159\/000542812","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T17:00:50Z","timestamp":1737565250000},"page":"41-49","source":"Crossref","is-referenced-by-count":5,"title":["Swallowed Topical Tacrolimus Induces Clinical and Histological Remission in a Subset of Patients with Severe Lymphocytic Esophagitis"],"prefix":"10.1159","volume":"10","author":[{"given":"Alain","family":"Schoepfer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Asikainen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc","family":"Biedermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Kreienbuehl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Godat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corina","family":"Dommann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Straumann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Greuter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1309\/7lablgy08uem3h26"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.03.002"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1111\/all.15233"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i6.949"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3182500de8"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-017-0564-y"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03800.x"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20797"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/s0167-4889(00)00082-3"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1002\/j.1460-2075.1994.tb06329.x"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.02.027"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1159\/000486131"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.05.045"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-301817"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.11.032"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2022.05.013"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.28130"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.5114\/ada.2019.91425"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.2165\/00044011-200626050-00001"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.09.049"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S19027"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1159\/000493979"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.03.025"}],"container-title":["Inflammatory Intestinal Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/iid\/article-pdf\/10\/1\/41\/4326294\/000542812.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/iid\/article-pdf\/10\/1\/41\/4326294\/000542812.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:03:18Z","timestamp":1745420598000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000542812"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,21]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000542812","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.28203209","asserted-by":"subject"}]},"ISSN":["2296-9403","2296-9365"],"issn-type":[{"value":"2296-9403","type":"print"},{"value":"2296-9365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,21]]}}}