PMID- 35384368 OWN - NLM STAT- MEDLINE DCOM- 20220413 LR - 20220527 IS - 2050-6414 (Electronic) IS - 2050-6406 (Print) IS - 2050-6406 (Linking) VI - 10 IP - 3 DP - 2022 Apr TI - Close follow-up is associated with fewer stricture formation and results in earlier detection of histological relapse in the long-term management of eosinophilic esophagitis. PG - 308-318 LID - 10.1002/ueg2.12216 [doi] AB - BACKGROUND AND AIMS: No recommendations exist regarding optimal follow-up schedule in patients with eosinophilic esophagitis (EoE) under maintenance treatment. METHODS: We retrospectively evaluated a long-term surveillance concept at the Swiss EoE clinic, where clinical, endoscopic and histological disease activity is assessed annually regardless of EoE symptoms. Data on 159 adult patients under maintenance steroid treatment with available follow-up were analyzed. Patients were classified as having close (duration between visits <18 months) or non-close follow-up (>/=18 months). RESULTS: We analyzed a total of 309 follow-up visits of 159 patients (123 males, age at diagnosis 38.9 +/- 15.4 years). 157 (51%) visits were within a close follow-up schedule (median duration between visits of 1.0 years (interquartile range (IQR) 0.9-1.2)), while 152 visits (49%) were not (median duration between visits 2.9 years (IQR 2.0-4.1)). There was no difference regarding ongoing clinical, endoscopic, and histological disease activity, and adherence to prescribed steroid treatment between the two groups. However, stricture formation was significantly less frequently observed at visits within a close follow-up schedule (22.9 vs. 33.6%, p = 0.038). Absence of close follow-up was a significant risk factor for stricture development in a multivariate regression model. Patients who achieved histological remission and were followed within a close-follow-up schedule had significantly earlier detection of histological relapse compared to patients not within such close follow-up. CONCLUSION: Close follow-up is associated with fewer stricture formation and appears to result in earlier detection of histological relapse in patients with eosinophilic esophagitis. We advocate for regular assessment of disease activity (every 12-18 months) in order to detect relapsing disease as early as possible, and therefore potentially minimize the risk for EoE complications. CI - (c) 2022 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology. FAU - Bon, Lorenz AU - Bon L AD - Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland. FAU - Safroneeva, Ekaterina AU - Safroneeva E AD - Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. FAU - Bussmann, Christian AU - Bussmann C AD - Pathology Viollier AG, Basel, Switzerland. FAU - Biedermann, Luc AU - Biedermann L AD - Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland. FAU - Schreiner, Philipp AU - Schreiner P AUID- ORCID: 0000-0003-1610-1925 AD - Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland. FAU - Vavricka, Stephan R AU - Vavricka SR AD - Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland. AD - Center for Gastroenterology and Hepatology, Zurich, Switzerland. FAU - Schoepfer, Alain M AU - Schoepfer AM AD - Division of Gastroenterology and Hepatology, University Hospital Lausanne - Centre Hopitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland. FAU - McCright-Gill, Talaya AU - McCright-Gill T AD - Mount Sinai Center for Eosinophilic Disorders, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Simon, Hans-Uwe AU - Simon HU AD - Institute of Biochemistry, Medical School Brandenburg, Neuruppin, Germany. AD - Institute of Pharmacology, University of Bern, Bern, Switzerland. FAU - Straumann, Alex AU - Straumann A AD - Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland. FAU - Chehade, Mirna AU - Chehade M AD - Mount Sinai Center for Eosinophilic Disorders, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Greuter, Thomas AU - Greuter T AUID- ORCID: 0000-0003-2065-3925 AD - Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland. AD - Division of Gastroenterology and Hepatology, University Hospital Lausanne - Centre Hopitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland. LA - eng GR - U54 AI117804 CEGIR training grant/NH/NIH HHS/United States GR - U2C TR002818/TR/NCATS NIH HHS/United States GR - 32003B_160115/SNSF_/Swiss National Science Foundation/Switzerland GR - U54 AI117804/AI/NIAID NIH HHS/United States GR - P2ZHP3_168561/SNSF_/Swiss National Science Foundation/Switzerland GR - 32003B_204751/1/SNSF_/Swiss National Science Foundation/Switzerland PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20220405 PL - England TA - United European Gastroenterol J JT - United European gastroenterology journal JID - 101606807 RN - 0 (Steroids) SB - IM MH - Adult MH - Chronic Disease MH - Constriction, Pathologic MH - *Eosinophilic Esophagitis/diagnosis/epidemiology/therapy MH - Follow-Up Studies MH - Humans MH - Male MH - Recurrence MH - Retrospective Studies MH - Steroids/therapeutic use PMC - PMC9004232 OTO - NOTNLM OT - eosinophilic esophagitis OT - esophagus OT - long-term outcome OT - relapse OT - swallowed topical corticosteroids COIS- Ekaterina Safroneeva is a consultant for Celgene Corp., Regeneron Pharmaceuticals Inc., and Novartis. Luc Biedermann has received consulting fees and/or speaker fees from Falk Pharma, Esocap, Sanofi-Aventis and Calypso Biotech. Philipp Schreiner received fees for consulting from Pfizer, Janssen and Takeda. Stephan R. Vavricka received consultant fees and unrestricted research grants from Vifor and Falk Pharma. Alain M. Schoepfer is a consultant for Falk Pharma, Adare Pharmaceuticals, Celgene-Receptos, and Sanofi-Regeneron. Hans-Uwe Simon is a consultant for AstraZeneca, GlaxoSmithKline, and Esocap. Alex Straumann has consulting contracts with Actelion, Celgene-Receptos, Falk Pharma, Roche-Genentech, GlaxoSmithKline, Novartis, Nutricia and Sanofi-Regeneron. Mirna Chehade received research support from Regeneron, Allakos, Shire/Takeda, AstraZeneca, Adare/Ellodi, Danone; and consulting fees from Regeneron, Allakos, Adare/Ellodi, Shire/Takeda, AstraZeneca, Sanofi, Bristol Myers Squibb, Phathom. Thomas Greuter has consulting contracts with Sanofi-Regeneron and Falk Pharma, received travel grants from Falk Pharma GmbH and Vifor, and an unrestricted research grant from Novartis. The other authors (Lorenz Bon, Christian Bussmann, Talaya McCright-Gill) have nothing to declare. No company representative was involved in conception, writing, or financing of this study. EDAT- 2022/04/07 06:00 MHDA- 2022/04/14 06:00 PMCR- 2022/04/05 CRDT- 2022/04/06 09:19 PHST- 2022/01/04 00:00 [received] PHST- 2022/02/05 00:00 [accepted] PHST- 2022/04/07 06:00 [pubmed] PHST- 2022/04/14 06:00 [medline] PHST- 2022/04/06 09:19 [entrez] PHST- 2022/04/05 00:00 [pmc-release] AID - UEG212216 [pii] AID - 10.1002/ueg2.12216 [doi] PST - ppublish SO - United European Gastroenterol J. 2022 Apr;10(3):308-318. doi: 10.1002/ueg2.12216. Epub 2022 Apr 5.