PMID- 36943488
OWN - NLM
STAT- MEDLINE
DCOM- 20240214
LR  - 20240326
IS  - 1539-2031 (Electronic)
IS  - 0192-0790 (Linking)
VI  - 58
IP  - 3
DP  - 2024 Mar 1
TI  - Baseline Peripheral Eosinophil Count Independently Predicts Proton Pump Inhibitor 
      Response in Eosinophilic Esophagitis.
PG  - 242-246
LID - 10.1097/MCG.0000000000001845 [doi]
AB  - GOALS: To assess the predictive value of baseline peripheral absolute eosinophil 
      counts (AECs) for proton pump inhibitor (PPI) response in eosinophilic 
      esophagitis (EoE). BACKGROUND: PPI leads to histologic remission in ~50% of EoE 
      patients, although there are few distinguishing clinical features between 
      PPI-responsive (PPI-r-EoE) and nonresponsive (PPI-nr-EoE) diseases. Peripheral 
      eosinophilia is present in ~50% of EoE cases and is associated with eosinophil 
      density on esophageal biopsy and worse clinical outcomes. The association between 
      peripheral eosinophilia and PPI-responsiveness in EoE remains unclear. STUDY: 
      This is a retrospective cohort study of adult EoE patients at a tertiary center 
      between 2012 and 2016. All patients underwent twice daily PPI trials for >/=8 weeks 
      followed by repeat esophageal biopsies and were classified as PPI-r-EoE or 
      PPI-nr-EoE based on histologic response (<15 eosinophils/high power field). 
      Baseline peripheral AEC was obtained within 1 month before index endoscopy. 
      Analyses were performed using Fisher exact/Student t test (univariate) and 
      logistic regression (multivariable). RESULTS: One hundred eighty-three patients 
      (91 PPI-nr-EoE and 92 PPI-r-EoE) were included. Mean peripheral AEC was higher 
      among PPI-nr-EoE patients (0.41 vs 0.24 K/microL, P = 0.013). Baseline peripheral 
      eosinophilia (>0.5 K/microL) was more prevalent among patients with PPI-nr-EoE (70.4% 
      vs 45.5%, P = 0.023) and a history of food impaction (51.9% vs 23.7%, P = 
      0.0082). On multivariable analyses, peripheral eosinophilia remained an 
      independent predictor for PPI response (adjacent odds ratio = 2.86, CI: 
      1.07-7.62, P = 0.036) and food impaction (adjacent odds ratio = 2.80, CI: 
      1.07-7.35, P = 0.037). CONCLUSIONS: Baseline peripheral eosinophilia 
      independently predicts PPI nonresponse and food impaction in EoE patients. 
      Peripheral AEC may help therapy selection in EoE and prevent delays in achieving 
      histologic remission.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Muftah, Mayssan
AU  - Muftah M
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital.
AD  - Harvard Medical School.
FAU - Barshop, Kenneth
AU  - Barshop K
AD  - Harvard Medical School.
AD  - Department of Medicine, Brigham and Women's Hospital, Boston, MA.
FAU - Redd, Walker D
AU  - Redd WD
AD  - Harvard Medical School.
AD  - Department of Medicine, Brigham and Women's Hospital, Boston, MA.
FAU - Goldin, Alison H
AU  - Goldin AH
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital.
AD  - Harvard Medical School.
FAU - Lo, Wai-Kit
AU  - Lo WK
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital.
AD  - Harvard Medical School.
FAU - Chan, Walter W
AU  - Chan WW
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital.
AD  - Harvard Medical School.
LA  - eng
PT  - Journal Article
DEP - 20240301
PL  - United States
TA  - J Clin Gastroenterol
JT  - Journal of clinical gastroenterology
JID - 7910017
RN  - 0 (Proton Pump Inhibitors)
RN  - Eosinophilic enteropathy
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Eosinophilic Esophagitis/complications
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Eosinophils/pathology
MH  - Retrospective Studies
MH  - Endoscopy, Gastrointestinal
MH  - *Enteritis
MH  - *Eosinophilia
MH  - *Gastritis
EDAT- 2023/03/22 06:00
MHDA- 2024/02/14 12:48
CRDT- 2023/03/21 12:15
PHST- 2022/11/06 00:00 [received]
PHST- 2023/02/24 00:00 [accepted]
PHST- 2024/02/14 12:48 [medline]
PHST- 2023/03/22 06:00 [pubmed]
PHST- 2023/03/21 12:15 [entrez]
AID - 00004836-202403000-00005 [pii]
AID - 10.1097/MCG.0000000000001845 [doi]
PST - epublish
SO  - J Clin Gastroenterol. 2024 Mar 1;58(3):242-246. doi: 
      10.1097/MCG.0000000000001845.