TY - JOUR
T1 - Efficacy of proton pump inhibitor therapy for eosinophilic oesophagitis in 630 patients
T2 - results from the EoE connect registry
AU - Laserna-Mendieta, Emilio J.
AU - Casabona, Sergio
AU - Guagnozzi, Danila
AU - Savarino, Edoardo
AU - Perelló, Antonia
AU - Guardiola-Arévalo, Antonio
AU - Barrio, Jesús
AU - Pérez-Martínez, Isabel
AU - Lund Krarup, Anne
AU - Alcedo, Javier
AU - de la Riva, Susana
AU - Rey-Iborra, Esther
AU - Santander, Cecilio
AU - Arias, Ángel
AU - Lucendo, Alfredo J.
AU - EUREOS EoE CONNECT Research group
N1 - © 2020 John Wiley & Sons Ltd.
PY - 2020/9
Y1 - 2020/9
N2 - Background: Proton pump inhibitors (PPIs) are the most commonly used first-line therapy for patients with eosinophilic oesophagitis (EoE). However, many aspects related to PPIs in EoE are still unknown. Aims: To assess the effectiveness of PPI therapy for EoE in real-world practice. Methods: This cross-sectional study collected data on PPI efficacy from the multicentre EoE CONNECT database. Clinical remission was defined as a decrease of ≥50% in dysphagia symptom score; histological remission was defined as a peak eosinophil count below 15 eosinophils per high-power field. Factors associated with effectiveness of PPI therapy were identified by binary logistic regression multivariate analyses. Results: Overall, 630 patients (76 children) received PPI as initial therapy (n = 600) or after failure to respond to other therapies (n = 30). PPI therapy achieved eosinophil density below 15 eosinophils per high-power field in 48.8% and a decreased symptom score in 71.0% of patients. More EoE patients with an inflammatory rather than stricturing phenotype accomplished clinico-histological remission after PPI therapy (OR 3.7; 95% CI, 1.4-9.5); as well as those who prolonged treatment length from 8 to 12 weeks (OR 2.7; 95% CI, 1.3-5.3). After achieving clinico-histological remission of EoE, PPI dosage reduction was effectively maintained in 69.9% of patients, but tended to be less effective among those with a stricturing phenotype. Conclusions: Inflammatory EoE phenotype and treatment duration up to 12 weeks correlated with greater chance for inducing remission of EoE. A stricturing phenotype decreased response rates to PPI therapy both initially and in the long term.
AB - Background: Proton pump inhibitors (PPIs) are the most commonly used first-line therapy for patients with eosinophilic oesophagitis (EoE). However, many aspects related to PPIs in EoE are still unknown. Aims: To assess the effectiveness of PPI therapy for EoE in real-world practice. Methods: This cross-sectional study collected data on PPI efficacy from the multicentre EoE CONNECT database. Clinical remission was defined as a decrease of ≥50% in dysphagia symptom score; histological remission was defined as a peak eosinophil count below 15 eosinophils per high-power field. Factors associated with effectiveness of PPI therapy were identified by binary logistic regression multivariate analyses. Results: Overall, 630 patients (76 children) received PPI as initial therapy (n = 600) or after failure to respond to other therapies (n = 30). PPI therapy achieved eosinophil density below 15 eosinophils per high-power field in 48.8% and a decreased symptom score in 71.0% of patients. More EoE patients with an inflammatory rather than stricturing phenotype accomplished clinico-histological remission after PPI therapy (OR 3.7; 95% CI, 1.4-9.5); as well as those who prolonged treatment length from 8 to 12 weeks (OR 2.7; 95% CI, 1.3-5.3). After achieving clinico-histological remission of EoE, PPI dosage reduction was effectively maintained in 69.9% of patients, but tended to be less effective among those with a stricturing phenotype. Conclusions: Inflammatory EoE phenotype and treatment duration up to 12 weeks correlated with greater chance for inducing remission of EoE. A stricturing phenotype decreased response rates to PPI therapy both initially and in the long term.
UR - http://www.scopus.com/inward/record.url?scp=85088094559&partnerID=8YFLogxK
U2 - 10.1111/apt.15957
DO - 10.1111/apt.15957
M3 - Journal article
C2 - 32677040
AN - SCOPUS:85088094559
SN - 0269-2813
VL - 52
SP - 798
EP - 807
JO - Alimentary Pharmacology and Therapeutics
JF - Alimentary Pharmacology and Therapeutics
IS - 5
ER -