Factors associated with treatment response in eosinophilic esophagitis patients: Experience from a pediatric tertiary care center.

IF 2.6 3区 医学 Q2 ALLERGY
Wimwipa Mongkonsritragoon, Ananya Varre, Serina Beydoun, Rahul Revan, Logan Gary, Ronald Thomas, Pavadee Poowuttikul, Divya Seth
{"title":"Factors associated with treatment response in eosinophilic esophagitis patients: Experience from a pediatric tertiary care center.","authors":"Wimwipa Mongkonsritragoon, Ananya Varre, Serina Beydoun, Rahul Revan, Logan Gary, Ronald Thomas, Pavadee Poowuttikul, Divya Seth","doi":"10.2500/aap.2025.46.240107","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> Eosinophilic esophagitis (EoE) is a disease characterized by eosinophilic inflammation of the esophagus and associated esophageal dysfunction with increasing worldwide prevalence. Clinical presentation is nonspecific and varies with age, with limited studies in the pediatric population. <b>Objective:</b> Our study aimed to compile clinical phenotypes, esophagogastroduodenoscopy findings, and treatment response of EoE in a tertiary pediatric center, and to examine factors associated with the response of treatment. <b>Methods:</b> In this retrospective study, we reviewed the medical records of 824 patients diagnosed with EoE at Children's Hospital of Michigan from 2011 to 2021. Data collected included a demographic profile, symptoms, esophagogastroduodenoscopic and histopathologic findings, treatment modalities, response, and compliance. We then performed a multivariable logistic regression to assess the associating factors that influenced the treatment response rate. <b>Results:</b> A high proportion of males and coexisting allergic conditions were observed in the patients with EoE, with the most common presentation of vomiting in children and of abdominal pain in adolescents. Among 656 of the 824 patients who had follow-up esophagogastroduodenoscopy, treatment response rates varied among modalities, with proton-pump inhibitor treatment exhibiting the highest response rate, at 60.8%, followed by diet modification (50%) and topical steroid treatment (43.5%). Significant predictors of normal endoscopic findings at follow-up included female gender, normal endoscopic appearance, good compliance to treatment, and absence of topical steroids in the treatment regimen. There were no significant differences in outcomes observed for targeted elimination led by a skin-prick test or specific immunoglobulin E test. Medication compliance did not significantly differ among the treatment options. <b>Conclusion:</b> Managing EoE in pediatric patients poses significant challenges, which emphasizes the need for multidisciplinary care to achieve treatment response effectively. The findings underscore the complexity of managing EoE and the need for individualized treatment approaches. Further research is warranted to elucidate the underlying mechanisms and optimize management strategies for pediatric patients with EoE.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 2","pages":"135-143"},"PeriodicalIF":2.6000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Allergy and asthma proceedings","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2500/aap.2025.46.240107","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Eosinophilic esophagitis (EoE) is a disease characterized by eosinophilic inflammation of the esophagus and associated esophageal dysfunction with increasing worldwide prevalence. Clinical presentation is nonspecific and varies with age, with limited studies in the pediatric population. Objective: Our study aimed to compile clinical phenotypes, esophagogastroduodenoscopy findings, and treatment response of EoE in a tertiary pediatric center, and to examine factors associated with the response of treatment. Methods: In this retrospective study, we reviewed the medical records of 824 patients diagnosed with EoE at Children's Hospital of Michigan from 2011 to 2021. Data collected included a demographic profile, symptoms, esophagogastroduodenoscopic and histopathologic findings, treatment modalities, response, and compliance. We then performed a multivariable logistic regression to assess the associating factors that influenced the treatment response rate. Results: A high proportion of males and coexisting allergic conditions were observed in the patients with EoE, with the most common presentation of vomiting in children and of abdominal pain in adolescents. Among 656 of the 824 patients who had follow-up esophagogastroduodenoscopy, treatment response rates varied among modalities, with proton-pump inhibitor treatment exhibiting the highest response rate, at 60.8%, followed by diet modification (50%) and topical steroid treatment (43.5%). Significant predictors of normal endoscopic findings at follow-up included female gender, normal endoscopic appearance, good compliance to treatment, and absence of topical steroids in the treatment regimen. There were no significant differences in outcomes observed for targeted elimination led by a skin-prick test or specific immunoglobulin E test. Medication compliance did not significantly differ among the treatment options. Conclusion: Managing EoE in pediatric patients poses significant challenges, which emphasizes the need for multidisciplinary care to achieve treatment response effectively. The findings underscore the complexity of managing EoE and the need for individualized treatment approaches. Further research is warranted to elucidate the underlying mechanisms and optimize management strategies for pediatric patients with EoE.

与嗜酸性粒细胞性食管炎患者治疗反应相关的因素:来自儿科三级保健中心的经验。
背景:嗜酸性粒细胞性食管炎(EoE)是一种以食管嗜酸性粒细胞性炎症和相关食管功能障碍为特征的疾病,在世界范围内越来越普遍。临床表现是非特异性的,随年龄而变化,在儿科人群中的研究有限。目的:我们的研究旨在收集某三级儿科中心EoE的临床表型、食管胃十二指肠镜检查结果和治疗反应,并探讨与治疗反应相关的因素。方法:在这项回顾性研究中,我们回顾了2011年至2021年在密歇根儿童医院诊断为EoE的824例患者的医疗记录。收集的资料包括人口统计资料、症状、食管胃十二指肠镜和组织病理学检查结果、治疗方式、反应和依从性。然后,我们进行了多变量逻辑回归来评估影响治疗反应率的相关因素。结果:EoE患者中男性比例高,同时存在过敏症状,以儿童呕吐和青少年腹痛为最常见的表现。在824例随访食管胃十二指肠镜检查的656例患者中,治疗反应率因治疗方式而异,质子泵抑制剂治疗的反应率最高,为60.8%,其次是饮食改变(50%)和局部类固醇治疗(43.5%)。随访时内镜检查结果正常的重要预测因素包括女性、内镜检查外观正常、对治疗的良好依从性以及治疗方案中不使用外用类固醇。由皮肤点刺试验或特异性免疫球蛋白E试验引起的靶向消除的结果没有显著差异。药物依从性在治疗方案之间没有显著差异。结论:儿科患者EoE的管理面临着重大挑战,这强调了多学科护理的必要性,以达到有效的治疗效果。研究结果强调了EoE管理的复杂性和个性化治疗方法的必要性。需要进一步的研究来阐明儿童外伤性脑炎的潜在机制和优化治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
5.70
自引率
35.70%
发文量
106
审稿时长
6-12 weeks
期刊介绍: Allergy & Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists. The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma. Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信