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Orodispersible Budesonide (ODB) ‘Jorveza’ is a topical glucocorticoid receptor agonist indicated for the management of eosinophilic oesophagitis (EoE), a benign atopic inflammatory disorder of the oesophagus. It up-regulates anti-inflammatory agents such as IL-10 and annexin-1, and eosinophilia is reduced through IL-5 and eotaxin-3 inhibition, leading to decreased inflammation, 1 and induces histological remission. ODB has also shown promise in managing post radio-frequency ablation strictures2 and other inflammatory oesophageal conditions, although only licensed for EoE.We have used ODB in 11-cases of non-eosinophilic oesophageal disease with dysphagia symptoms and no physiological evidence of reflux on 24-hour pH studies or major motility disorder on high resolution manometry. The treatment regimen included ODB 1mg taken twice daily for 12-weeks.We assessed clinical, endoscopic, and histological improvement. Following the 12-week course, all patients experienced an improvement in one, two or all parameters (table 1).81.8% of patients showed symptomatic resolution (54.5% displaying a complete improvement, 27.3% displaying a partial improvement) and 18.2% showing no symptomatic response.Of the patients that received a follow-up endoscopy, 80% showed complete endoscopic resolution and 20% displayed partial endoscopic response.Histologically, of the three patients that received a follow-up biopsy, two displayed a complete histological response, and one achieved a partial response.In summary, ODB is an efficacious drug utilised in the management of eosinophilic oesophagitis with a good safety profile. The promising clinical, endoscopic and histological responses observed in this group of patients suggest that ODB may have a broader therapeutic role beyond its current license.Further research is needed to validate and build on this experience.References Greuter T, Hirano I, Dellon ES. Emerging therapies for eosinophilic esophagitis. The Journal of Allergy and Clinical Immunology [Internet]. 2020 Jan 1 [cited 2022 Jan 1];145(1):38–45. Available from: https://pubmed.ncbi.nlm.nih.gov/31705907/Wang WL, Tsai YN, Hsu MH, Lin JT, Wang HP, Lee CT. Administration of oral prednisolone to prevent esophageal stricture after balloon-type radiofrequency ablation for ultralong-segment esophageal neoplasia. Gastrointestinal Endoscopy 2024 Aug;100(2):192–9.Abstract OC61 Table 1