PMID- 34447870
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210828
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 9
IP  - 8
DP  - 2021 Aug
TI  - Extent of eosinophilic esophagitis predicts response to treatment.
PG  - E1234-E1242
LID - 10.1055/a-1492-2650 [doi]
AB  - Background and study aim  The clinical impact of eosinophilic esophagitis (EoE) 
      limited to the distal esophagus (Lim-EE) vs. diffuse involvement (Dif-EE) is 
      unknown. This study compared clinical characteristics and outcomes of Lim-EE vs. 
      Dif-EE. Patients and methods  This retrospective, single-center study of patients 
      with EoE between December 2011 and December 2019 evaluated treatment response 
      based on repeated pathology and/or clinical improvement using comparative 
      statistics. Results  479 patients were identified (126 Lim-EE, 353 Dif-EE). 
      Lim-EE patients had a higher incidence of endoscopically identified esophagitis 
      (23.0 % vs. 14.7 %; P  = 0.04), were older (50.8 [SD 16.2] vs. 46.4 [SD 15.3] 
      years; P  = 0.007), and were more likely to present with iron deficiency anemia 
      (5.6 % vs. 1.7 %; P  = 0.05), dyspepsia (15.1 % vs. 8.8 %; P  = 0.06) or for 
      Barrett's surveillance (10.3 % vs. 3.7 %; P  = 0.02). Patients with Dif-EE 
      presented more frequently with dysphagia (57.2 % vs. 45.2 %; P  = 0.02). Both 
      groups had similar proton pump inhibitor (87.2 % vs. 83.3 %; P  = 0.37) and 
      steroid (12.8 % vs. 21.4 %; P  = 0.14) use. Patients with Lim-EE had a better 
      clinicopathologic response (61.5 % vs. 44.8 %; P  = 0.009). On multivariate 
      analysis, EoE extent predicted treatment response with an odds ratio of 1.89 
      (95 % confidence interval 1.13-3.20; P  = 0.02). However, treatment response 
      based only on repeat biopsy results showed no statistical difference between 
      Lim-EE (52.5 %) and Dif-EE (39.7 %; P  = 0.15). Conclusions  Lim-EE may represent 
      a distinct phenotype separate from Dif-EE, with more overlap with 
      gastroesophageal reflux disease and better treatment response.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Ghoz, Hassan
AU  - Ghoz H
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Stancampiano, Fernando F
AU  - Stancampiano FF
AD  - Division of Internal Medicine, Mayo Clinic, Jacksonville, Florida, United States.
FAU - Valery, Jose R
AU  - Valery JR
AD  - Division of Internal Medicine, Mayo Clinic, Jacksonville, Florida, United States.
FAU - Nordelo, Katie
AU  - Nordelo K
AD  - Clinical Research Internship Study Program (CRISP), Mayo Clinic, Jacksonville, 
      Florida, United States.
FAU - Malviya, Balkishan
AU  - Malviya B
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Lacy, Brian E
AU  - Lacy BE
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Francis, Dawn
AU  - Francis D
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - DeVault, Kenneth
AU  - DeVault K
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Bouras, Ernest
AU  - Bouras E
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
FAU - Krishna, Murli
AU  - Krishna M
AD  - Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, 
      Florida, United States.
FAU - Palmer, William C
AU  - Palmer WC
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, 
      United States.
LA  - eng
PT  - Journal Article
DEP - 20210716
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC8383079
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2021/08/28 06:00
MHDA- 2021/08/28 06:01
PMCR- 2021/08/01
CRDT- 2021/08/27 06:59
PHST- 2020/11/18 00:00 [received]
PHST- 2021/03/15 00:00 [accepted]
PHST- 2021/08/27 06:59 [entrez]
PHST- 2021/08/28 06:00 [pubmed]
PHST- 2021/08/28 06:01 [medline]
PHST- 2021/08/01 00:00 [pmc-release]
AID - 10.1055/a-1492-2650 [doi]
PST - ppublish
SO  - Endosc Int Open. 2021 Aug;9(8):E1234-E1242. doi: 10.1055/a-1492-2650. Epub 2021 
      Jul 16.