PMID- 34120859 OWN - NLM STAT- MEDLINE DCOM- 20220207 LR - 20220207 IS - 1878-3562 (Electronic) IS - 1590-8658 (Linking) VI - 53 IP - 11 DP - 2021 Nov TI - Proton pump inhibitor therapy reverses endoscopic features of fibrosis in eosinophilic esophagitis. PG - 1479-1485 LID - S1590-8658(21)00276-0 [pii] LID - 10.1016/j.dld.2021.05.025 [doi] AB - BACKGROUND: Long-standing inflammation leads to esophageal remodeling with stricture formation in patients with eosinophilic esophagitis (EoE). The ability of proton pump inhibitors (PPI) to reverse endoscopic features of fibrosis is still unknown. OBJECTIVE: To investigate the effect of a short course of PPI treatment in reducing endoscopic findings indicative of esophageal fibrosis in EoE patients. METHODS: Cross-sectional analysis of the EoE CONNECT registry. Patients who received PPI to induce EoE remission were evaluated. Endoscopic features were graded using the EoE Endoscopic Reference Score (EREFS), with rings and strictures indicating fibrosis. Results were compared to those from patients treated with swallowed topic corticosteroids (STC). RESULTS: Clinico-histological remission was achieved in 83/166 adult patients treated with PPI (50%) and in 65/79 (82%) treated with STC; among responders, 60 (36%) and 57 (72%) patients respectively achieved deep histological remission (<5 eosinophils/hpf). At baseline, mean+/-SD EREFS was lower in patients treated with PPI compared to those who received STC (p < 0.001). Short term treatment significantly reduced EREFS scores in patients treated either with PPI or STC as well as rings and strictures. Among patients treated with PPI, deep histological remission (<5 eosinophils/hpf) provided further reduction in total EREFS score. CONCLUSION: Effective PPI therapy for EoE significantly reduced endoscopic esophageal fibrosis in the short term. CI - Copyright (c) 2021. Published by Elsevier Ltd. FAU - Navarro, Pilar AU - Navarro P AD - Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain. FAU - Laserna-Mendieta, Emilio J AU - Laserna-Mendieta EJ AD - Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain; Instituto de Investigacion Sanitaria Princesa (IIS-IP), Madrid, Spain; Clinical Laboratory, Hospital Universitario de La Princesa, Madrid, Spain. FAU - Guagnozzi, Danila AU - Guagnozzi D AD - Department of Gastroenterology, Hospital Universitario Vall d'Hebron, Barcelona, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBERehd), Madrid, Spain. FAU - Casabona, Sergio AU - Casabona S AD - Instituto de Investigacion Sanitaria Princesa (IIS-IP), Madrid, Spain; Department of Gastroenterology, Hospital Universitario La Princesa, Madrid, Spain. FAU - Perello, Antonia AU - Perello A AD - Department of Gastroenterology, Hospital de Viladecans, Barcelona, Spain. FAU - Savarino, Edoardo AU - Savarino E AD - Department of Surgery, Oncology and Gastroenterology, Universita di Padova, Padova, Italy. FAU - de la Riva, Susana AU - de la Riva S AD - Clinica Universidad de Navarra, Pamplona, Spain. FAU - Olalla, Jose Maria AU - Olalla JM AD - Department of Gastroenterology Clinica Universidad de Navarra, Pamplona, Spain. FAU - Ghisa, Matteo AU - Ghisa M AD - Department of Surgery, Oncology and Gastroenterology, Universita di Padova, Padova, Italy. FAU - Serrano-Moya, Natalia AU - Serrano-Moya N AD - Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain. FAU - Alcolea-Valero, Carmen AU - Alcolea-Valero C AD - Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain. FAU - Ortega-Rabbione, Guillermo AU - Ortega-Rabbione G AD - Instituto de Investigacion Sanitaria Princesa (IIS-IP), Madrid, Spain; Data Analysis Unit, Health Research Institute Hospital Universitario de la Princesa, Madrid, Spain. FAU - Majano, Pedro AU - Majano P AD - Research Unit, Hospital Universitario La Princesa, Madrid, Spain; Instituto de Investigacion Sanitaria Princesa (IIS-IP), Madrid, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBERehd), Madrid, Spain. FAU - Santander, Cecilio AU - Santander C AD - Instituto de Investigacion Sanitaria Princesa (IIS-IP), Madrid, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBERehd), Madrid, Spain; Department of Gastroenterology, Hospital Universitario La Princesa, Madrid, Spain; Department of Medicine, Universidad Autonoma de Madrid, Madrid, Spain. FAU - Arias, Angel AU - Arias A AD - Research Unit, Hospital General La Mancha Centro, Alcazar de San Juan, Ciudad. Real, Spain; Instituto de Investigacion Sanitaria Princesa (IIS-IP), Madrid, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBERehd), Madrid, Spain. FAU - Lucendo, Alfredo J AU - Lucendo AJ AD - Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain; Instituto de Investigacion Sanitaria Princesa (IIS-IP), Madrid, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBERehd), Madrid, Spain. Electronic address: ajlucendo@hotmail.com. CN - EUREOS EoE CONNECT research group LA - eng PT - Journal Article DEP - 20210610 PL - Netherlands TA - Dig Liver Dis JT - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JID - 100958385 RN - 0 (Proton Pump Inhibitors) SB - IM CIN - Dig Liver Dis. 2021 Nov;53(11):1476-1478. PMID: 34531128 MH - Adult MH - Cross-Sectional Studies MH - Endosonography MH - Eosinophilic Esophagitis/diagnosis/*drug therapy MH - Esophageal Stenosis/diagnostic imaging MH - Female MH - Humans MH - Male MH - Middle Aged MH - Proton Pump Inhibitors/*administration & dosage MH - Registries MH - Remission Induction/*methods MH - Retrospective Studies OTO - NOTNLM OT - Adrenal cortex hormones/therapeutic use OT - Disease management OT - Endoscopy OT - Eosinophilic esophagitis OT - Fibrosis OT - Proton pump inhibitors/therapeutic use OT - Swallowed topic steroids COIS- Conflict of interest None of the authors have any conflict of interest to declare. EDAT- 2021/06/15 06:00 MHDA- 2022/02/08 06:00 CRDT- 2021/06/14 06:18 PHST- 2020/11/12 00:00 [received] PHST- 2021/04/15 00:00 [revised] PHST- 2021/05/14 00:00 [accepted] PHST- 2021/06/15 06:00 [pubmed] PHST- 2022/02/08 06:00 [medline] PHST- 2021/06/14 06:18 [entrez] AID - S1590-8658(21)00276-0 [pii] AID - 10.1016/j.dld.2021.05.025 [doi] PST - ppublish SO - Dig Liver Dis. 2021 Nov;53(11):1479-1485. doi: 10.1016/j.dld.2021.05.025. Epub 2021 Jun 10.