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Efficacy of proton pump inhibitor therapy for eosinophilic oesophagitis in 630 patients: results from the EoE connect registry
Author(s) -
LasernaMendieta Emilio J.,
Casabona Sergio,
Guagnozzi Danila,
Savarino Edoardo,
Perelló Antonia,
GuardiolaArévalo Antonio,
Barrio Jesús,
PérezMartínez Isabel,
Lund Krarup Anne,
Alcedo Javier,
Riva Susana,
ReyIborra Esther,
Santander Cecilio,
Arias Ángel,
Lucendo Alfredo J.
Publication year - 2020
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.15957
Subject(s) - medicine , dysphagia , eosinophilic esophagitis , high power field , proton pump inhibitor , gastroenterology , eosinophil , logistic regression , surgery , disease , asthma , immunohistochemistry
Summary 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.