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1. Determinant factors for first-line treatment choice and effectiveness in pediatric eosinophilic esophagitis: an analysis of the EUREOS EoE CONNECT registry

Author

Navarro, Pilar, Feo‐Ortega, Sara, Casabona‐Francés, Sergio, Gutiérrez‐Junquera, Carolina, Savarino, Edoardo V., Amorena, Edurne, Fernández‐Fernández, Sonia, Pérez‐Martínez, Isabel, Oliva, Salvatore, Barrio, Jesús, Masiques‐Mas, Maria Lluisa, Guardiola‐Arévalo, Antonio, Guagnozzi, Danila, Racca, Francesca, Betoré, Elena, Votto, Martina, Rodríguez-Sánchez, Alba, Barrio, Mónica Llorente, Blas‐Jhon, Leonardo, Sánchez‐Vegazo, Carlos Teruel, García-Morales, Natalia, Krarup, Anne Lund, Dainese, Raffaella, Martín‐Dominguez, Verónica, García-Díaz, Alejandro, Maniero, Daria, Santander, Cecilio, Arias, Ángel, Laserna‐Mendieta, Emilio J., and Lucendo, Alfredo J.

Published
2024
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3. Safety and effectiveness of vedolizumab in paediatric patients with inflammatory bowel disease: an observational multicentre Spanish study

Author

Garcia-Romero, Ruth, Martinez de Zabarte Fernandez, José Miguel, Pujol-Muncunill, Gemma, Donat-Aliaga, Ester, Segarra-Cantón, Oscar, Irastorza-Terradillos, Iñaki, Medina-Benitez, Enrique, Ruiz-Hernández, Carlos José, Carrillo-Palau, Marta, Ros-Arnal, Ignacio, Rodriguez-Martínez, Alejandro, Escartin-Madurga, Laura, Gutiérrez-Junquera, Carolina, Vicente-Santamaría, Saioa, Velasco Rodriguez-Belvis, Marta, Fernández-Fernández, Sonia, Alberto-Alonso, José Ramón, Montraveta, Montserrat, Torres-Peral, Ricardo, Navalon-Rubio, María, Navas-López, Víctor Manuel, and Martin de Carpi, Javier

Published
2021
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4. Swallowed topical corticosteroids for eosinophilic esophagitis: Utilization and real‐world efficacy from the EoE CONNECT registry

Author

Laserna‐Mendieta, Emilio J., Navarro, Pilar, Casabona‐Francés, Sergio, Savarino, Edoardo V., Amorena, Edurne, Pérez‐Martínez, Isabel, Guagnozzi, Danila, Blas‐Jhon, Leonardo, Betoré, Elena, Guardiola‐Arévalo, Antonio, Pellegatta, Gaia, Krarup, Anne Lund, Perello, Antonia, Barrio, Jesús, Gutiérrez‐Junquera, Carolina, Teruel Sánchez‐Vegazo, Carlos, Fernández‐Fernández, Sonia, Naves, Juan Enrique, Oliva, Salvatore, Rodríguez‐Oballe, Juan Armando, Carrión, Silvia, Espina, Silvia, Llorente Barrio, Mónica, Masiques‐Mas, Maria Lluisa, Dainese, Raffaella, Feo‐Ortega, Sara, Martín‐Dominguez, Verónica, Fernández‐Pacheco, Jennifer, Pérez‐Fernández, Maria Teresa, Ghisa, Matteo, Maniero, Daria, Nantes‐Castillejo, Óscar, Nicolay‐Maneru, Julia, Suárez, Adolfo, Maray, Iván, Llerena‐Castro, Ronald, Ortega‐Larrodé, Adriana, Alcedo, Javier, Granja Navacerrada, Alicia, Racca, Francesca, Santander, Cecilio, Arias, Ángel, and Lucendo, Alfredo J.

Abstract

Swallowed topical corticosteroids (tC) are common therapy for patients with eosinophilic esophagitis (EoE). Widely heterogeneous results have occurred due to their active ingredients, formulations and doses. To assess the effectiveness of topical corticosteroid therapy for EoE in real‐world practice. Cross‐sectional study analysis of the multicentre EoE CONNECT registry. Clinical remission was defined as a decrease of ≥50% in dysphagia symptom scores; histological remission was defined as a peak eosinophil count below 15 per high‐power field. The effectiveness in achieving clinico‐histological remission (CHR) was compared for the main tC formulations. Overall, data on 1456 prescriptions of tC in monotherapy used in 866 individual patients were assessed. Of those, 904 prescriptions with data on formulation were employed for the induction of remission; 234 reduced a previously effective dose for maintenance. Fluticasone propionate formulations dominated the first‐line treatment, while budesonide was more common in later therapies. A swallowed nasal drop suspension was the most common formulation of fluticasone propionate. Doses ≥0.8 mg/day provided a 65% CHR rate and were superior to lower doses. Oral viscous solution prepared by a pharmacist was the most common prescription of budesonide; 4 mg/day provided no benefit over 2 mg/day (CHR rated being 72% and 80%, respectively). A multivariate analysis revealed budesonide orodispersible tablets as the most effective therapy (OR 18.9, p< 0.001); use of higher doses (OR 4.3, p= 0.03) and lower symptom scores (OR 0.9, p= 0.01) were also determinants of effectiveness. Reduced symptom severity, use of high doses, and use of budesonide orodispersible tablets particularly were all independent predictors of tC effectiveness.

Published
2024
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5. Correction to: Safety and effectiveness of vedolizumab in paediatric patients with inflammatory bowel disease: an observational multicenter Spanish study

Author

Garcia-Romero, Ruth, de Zabarte Fernandez, José Miguel Martinez, Pujol-Muncunill, Gemma, Donat-Aliaga, Ester, Segarra-Cantón, Oscar, Irastorza-Terradillos, Iñaki, Medina-Benitez, Enrique, Ruiz-Hernández, Carlos José, Carrillo-Palau, Marta, Ros-Arnal, Ignacio, Rodriguez-Martínez, Alejandro, Escartin-Madurga, Laura, Gutiérrez-Junquera, Carolina, Vicente-Santamaría, Saioa, Rodriguez-Belvis, Marta Velasco, Fernández-Fernández, Sonia, Alberto-Alonso, José Ramón, Montraveta, Montserrat, Torres-Peral, Ricardo, Navalon-Rubio, María, Navas-López, Víctor Manuel, and de Carpi, Javier Martin

Published
2021
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6. Psychometric evaluation of the Spanish version of the Pediatric Quality of Life Eosinophilic Esophagitis Questionnaire (Peds QL-EoE Module ™).

Author

Garcia – Martinez de Bartolomé, Ruth, Barrio-Torres, Josefa, Cilleruelo- Pascual, MLuz, Rodríguez-Soler, Juan José, Gil-de Miguel, Ángel, Sebastián-Viana, Tomás, the Spanish Study Group of Children's Eosinophilic Esophagitis Quality of Life, Vila-Miravet, Víctor, La Orden-Izquierdo, Enrique, Fernández-Fernández, Sonia, Herrero-Álvarez, Myriam, Soria-López, Marta, Botija-Arcos, Gonzalo, Rodríguez-Martínez, Alejandro, Galicia-Poblet, Gonzalo, García-Díaz, Alejandro, Herreros-Sáenz, Marta, Blasco-Alonso, Javier, Rodrigo-García, Gloria, and Alonso-Pérez, Natalia

Subjects
EOSINOPHILIC esophagitis, QUALITY of life, PSYCHOMETRICS, CRONBACH'S alpha, EXPLORATORY factor analysis
Abstract

Background: The Paediatric Eosinophilic Oesophagitis Module (PedsQL-EoE) was developed in English as a valid and reliable questionnaire to assess health-related quality of life (HRQoL) in children with EoE. The aim of this study was to evaluate the validity and reliability of the PedsQL-EoE that was previously adapted to Spanish by our group. Methods: This cross-sectional multicentre study was conducted in 36 paediatric gastroenterology units. Groups with and without dietary restrictions were studied separately. The PedsQL-EoE consists of 33 items divided into seven factors. Age-specific versions of the PedsQL-EoE were sent by e-mail to children and parents. Statistical analysis was used to study the questionnaire structure by means of exploratory factor analysis and interitem correlations. Confirmatory factor analysis (CFA) was applied to verify the proposed model as well as its psychometric properties through SMSR (standardized root mean square), outer loadings and R-square. To study construct validity and reliability, Cronbach´s alpha coefficient, convergent validity (AVE), discriminant validity (HTMT) and intraclass correlation coefficients (ICC) were used. Results: A total of 341 children and 394 parents participated with 307 matched answers. The median age was 12 years, and 75% were male. The questionnaire structure explained 68% and 66% of the total variance for parents and children, respectively. Five items showed negative correlations and were removed from the questionnaire. CFA applied to the new model supported the following construct: SMRS was less than 0.08, outer loadings measured above 0.5, and R2 explained more than 89% of the total variance. Once the modifications were performed, good internal consistency was demonstrated, with Cronbach's alpha values > 0.7, AVE values > 0.5 and HTMT < 0.9 with good child/parent agreement (ICC = 0.80). The most robust model of the PedsQL-EoE module was formed by seven factors: Symptoms I (6 items), Symptoms II (4 items), Treatment (4 items), Worries (3 items), Communication (5 items), Food and Eating (3 items) and Food Feelings (3 items). Conclusions: The final PedsQL-EoE Module version, after the removal of five items, is a valid and reliable tool to be used in children with EoE. The Spanish validated version appears to be a useful instrument for measuring the impact of EoE on Spanish children´s quality of life. [ABSTRACT FROM AUTHOR]

Published
2023
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7. Corrigendum to “Differences between childhood- and adulthood-onset eosinophilic esophagitis: An analysis from the EoE connect registry” [Digestive and Liver Disease Volume 55, Issue 3, March 2023, Pages 350–359]

Author

Laserna-Mendieta, Emilio José, primary, Navarro, Pilar, additional, Casabona-Francés, Sergio, additional, Savarino, Edoardo V, additional, Pérez-Martínez, Isabel, additional, Guagnozzi, Danila, additional, Barrio, Jesús, additional, Perello, Antonia, additional, Guardiola-Arévalo, Antonio, additional, Betoré-Glaria, María Elena, additional, Blas-Jhon, Leonardo, additional, Racca, Francesca, additional, Krarup, Anne Lund, additional, Gutiérrez-Junquera, Carolina, additional, Fernández-Fernández, Sonia, additional, De la Riva, Susana, additional, Naves, Juan E, additional, Carrión, Silvia, additional, García-Morales, Natalia, additional, Roales, Valentín, additional, Rodríguez-Oballe, Juan Armando, additional, Dainese, Raffaella, additional, Rodríguez-Sánchez, Alba, additional, Masiques-Mas, María Lluisa, additional, Feo-Ortega, Sara, additional, Ghisa, Matteo, additional, Maniero, Daria, additional, Suarez, Adolfo, additional, Llerena-Castro, Ronald, additional, Gil-Simón, Paula, additional, de la Peña-Negro, Luisa, additional, Granja-Navacerrada, Alicia, additional, Alcedo, Javier, additional, Hurtado de Mendoza-Guena, Lonore, additional, Pellegatta, Gaia, additional, Pérez-Fernández, María Teresa, additional, Santander, Cecilio, additional, Tamarit-Sebastián, Sonsoles, additional, Arias, Ángel, additional, and Lucendo, Alfredo J., additional

Published
2023
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9. Recommendations for the diagnosis and practical management of paediatric eosinophilic oesophagitis

Author

Alonso Vicente, Carmen, Álvarez Beltrán, Marina, Barrio Torres, Josefa, Barros García, Patricia, Colomé Rivero, Gemma, Javier Eizaguirre Arocena, Francisco, Fernández Caamaño, Beatriz, Orden Izquierdo, Enrique la, Leis Trabazo, Rosaura, Lorenzo Garrido, Helena, Medina Benítez, Enrique, Montraveta Querol, Montserrat, Vecino López, Raquel, Gutiérrez Junquera, Carolina, Fernández Fernández, Sonia, Domínguez-Ortega, Gloria, Vila Miravet, Víctor, García Puig, Roger, García Romero, Ruth, Fernández de Valderrama, Ana, and Andradas Rivas, Rebeca

Published
2020
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10. Recomendaciones para el diagnóstico y manejo práctico de la esofagitis eosinofílica pediátrica

Author

Alonso Vicente, Carmen, Álvarez Beltrán, Marina, Barrio Torres, Josefa, Barros García, Patricia, Colomé Rivero, Gemma, Javier Eizaguirre Arocena, Francisco, Fernández Caamaño, Beatriz, Orden Izquierdo, Enrique la, Leis Trabazo, Rosaura, Lorenzo Garrido, Helena, Medina Benítez, Enrique, Montraveta Querol, Montserrat, Vecino López, Raquel, Gutiérrez Junquera, Carolina, Fernández Fernández, Sonia, Domínguez-Ortega, Gloria, Vila Miravet, Víctor, García Puig, Roger, García Romero, Ruth, Fernández de Valderrama, Ana, and Andradas Rivas, Rebeca

Published
2020
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14. Differences between childhood- and adulthood-onset eosinophilic esophagitis: An analysis from the EoE connect registry

Author

Laserna-Mendieta, Emilio José, primary, Navarro, Pilar, additional, Casabona-Francés, Sergio, additional, Savarino, Edoardo V, additional, Pérez-Martínez, Isabel, additional, Guagnozzi, Danila, additional, Barrio, Jesús, additional, Perello, Antonia, additional, Guardiola-Arévalo, Antonio, additional, Betoré-Glaria, María Elena, additional, Blas-Jhon, Leonardo, additional, Racca, Francesca, additional, Krarup, Anne Lund, additional, Gutiérrez-Junquera, Carolina, additional, Fernández-Fernández, Sonia, additional, la Riva, Susana De, additional, Naves, Juan E, additional, Carrión, Silvia, additional, García-Morales, Natalia, additional, Roales, Valentín, additional, Rodríguez-Oballe, Juan Armando, additional, Dainese, Raffaella, additional, Rodríguez-Sánchez, Alba, additional, Masiques-Mas, María Lluisa, additional, Feo-Ortega, Sara, additional, Ghisa, Matteo, additional, Maniero, Daria, additional, Suarez, Adolfo, additional, Llerena-Castro, Ronald, additional, Gil-Simón, Paula, additional, Peña-Negro, Luisa de la, additional, Granja-Navacerrada, Alicia, additional, Alcedo, Javier, additional, Hurtado de Mendoza-Guena, Lonore, additional, Pellegatta, Gaia, additional, Pérez-Fernández, María Teresa, additional, Santander, Cecilio, additional, Tamarit-Sebastián, Sonsoles, additional, Arias, Ángel, additional, and Lucendo, Alfredo J, additional

Published
2022
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17. Differences between childhood- and adulthood-onset eosinophilic esophagitis: An analysis from the EoE connect registry.

Author

Laserna-Mendieta, Emilio José, Navarro, Pilar, Casabona-Francés, Sergio, Savarino, Edoardo V, Pérez-Martínez, Isabel, Guagnozzi, Danila, Barrio, Jesús, Perello, Antonia, Guardiola-Arévalo, Antonio, Betoré-Glaria, María Elena, Blas-Jhon, Leonardo, Racca, Francesca, Krarup, Anne Lund, Gutiérrez-Junquera, Carolina, Fernández-Fernández, Sonia, la Riva, Susana De, Naves, Juan E, Carrión, Silvia, García-Morales, Natalia, and Roales, Valentín

Abstract

Direct comparisons of childhood- and adulthood-onset eosinophilic esophagitis (EoE) are scarce. To compare disease characteristics, endoscopic and histological features, allergic concomitances and therapeutic choices across ages. Cross-sectional analysis of the EoE CONNECT registry. The adulthood-onset cohort (those diagnosed at ≥18y) comprised 1044 patients and the childhood‐onset cohort (patients diagnosed at <18 y), 254. Vomiting, nausea, chest and abdominal pain, weight loss, slow eating and food aversion were significantly more frequent in children; dysphagia, food bolus impaction and heartburn predominated in adults. A family history of EoE was present in 16% of pediatric and 8.2% of adult patients (p <0.001). Concomitant atopic diseases did not vary across ages. Median±IQR diagnostic delay (years) from symptom onset was higher in adults (2.7 ± 6.1) than in children (1 ± 2.1; p <0.001). Esophageal strictures and rings predominated in adults (p <0.001), who underwent esophageal dilation more commonly (p = 0.011). Inflammatory EoE phenotypes were more common in children (p = 0.001), who also presented higher eosinophil counts in biopsies (p = 0.015) and EREFS scores (p = 0.017). Despite PPI predominating as initial therapy in all cohorts, dietary therapy and swallowed topical corticosteroids were more frequently prescribed in children (p <0.001). Childhood‐onset EoE has differential characteristics compared with adulthood-onset, but similar response to treatment. [ABSTRACT FROM AUTHOR]

Published
2023
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18. Accurate and timely diagnosis of Eosinophilic Esophagitis improves over time in Europe. An analysis of the EoE CONNECT Registry

Author

Navarro, Pilar, primary, Laserna‐Mendieta, Emilio J, additional, Casabona, Sergio, additional, Savarino, Edoardo, additional, Pérez‐Fernández, María Teresa, additional, Ghisa, Matteo, additional, Pérez‐Martínez, Isabel, additional, Guagnozzi, Danila, additional, Perelló, Antonia, additional, Guardiola‐Arévalo, Antonio, additional, Racca, Francesca, additional, Betoré, Elena, additional, Blas‐Jhon, Leonardo, additional, Krarup, Anne Lund, additional, Martín‐Domínguez, Verónica, additional, Maniero, Daria, additional, Suárez, Adolfo, additional, Llerena‐Castro, Ronald, additional, de la Peña‐Negro, Luisa, additional, Navacerrada, Alicia Granja, additional, Pellegatta, Gaia, additional, Alcedo, Javier, additional, de Hurtado Mendoza‐Guena, Lonore, additional, Feo‐Ortega, Sara, additional, Barrio, Jesús, additional, Gutiérrez‐Junquera, Carolina, additional, Fernández‐Fernández, Sonia, additional, De la Riva, Susana, additional, E Navés, Juan, additional, Carrión, Silvia, additional, Ciriza de los Ríos, Constanza, additional, García‐Morales, Natalia, additional, Rodríguez‐Oballe, Juan Armando, additional, Dainese, Raffaela, additional, Rodríguez‐Sánchez, Alba, additional, Masiques‐Mas, María Lluisa, additional, Palomeque, María Teresa, additional, Santander, Cecilio, additional, Tamarit‐Sebastián, Sonsoles, additional, Arias, Ángel, additional, and Lucendo, Alfredo J, additional

Published
2022
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19. EoE CONNECT, the European Registry of Clinical, Environmental, and Genetic Determinants in Eosinophilic Esophagitis: rationale, design, and study protocol of a large-scale epidemiological study in Europe

Author

Lucendo, Alfredo J., primary, Santander, Cecilio, additional, Savarino, Edoardo, additional, Guagnozzi, Danila, additional, Pérez-Martínez, Isabel, additional, Perelló, Antonia, additional, Guardiola-Arévalo, Antonio, additional, Barrio, Jesús, additional, Elena Betoré-Glaria, María, additional, Gutiérrez-Junquera, Carolina, additional, Ciriza de los Ríos, Constanza, additional, Racca, Francesca, additional, Fernández-Fernández, Sonia, additional, Blas-Jhon, Leonardo, additional, Lund Krarup, Anne, additional, de la Riva, Susana, additional, Naves, Juan E., additional, Carrión, Silvia, additional, Rodríguez Oballe, Juan Armando, additional, García-Morales, Natalia, additional, Tamarit-Sebastián, Sonsoles, additional, Navarro, Pilar, additional, Arias, Ángel, additional, Laserna-Mendieta, Emilio J., additional, Casabona-Francés, Sergio, additional, Pérez-Fernández, Teresa, additional, Llerena Castro, Roland, additional, Ghisa, Matteo, additional, Manie, Daria, additional, Pellegatta, Gaia, additional, Suárez, Adolfo, additional, Alcedo, Javier, additional, Gil Simón, Paula, additional, Teresa Palomeque, María, additional, Asensio, Teresa, additional, Granja-Navacerrada, Alicia, additional, de Mendoza Guena, Lonore Hurtado, additional, Rodríguez Sánchez, Alba, additional, Masiques Mas, Lluïsa, additional, Dainese, Raffaella, additional, and Feo-Ortega, Sara, additional

Published
2022
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20. Proton pump inhibitor therapy in pediatric eosinophilic esophagitis: predictive factors and long-term step-down efficacy.

Author

Gutiérrez-Junquera, Carolina, Fernández-Fernández, Sonia, Domínguez-Ortega, Gloria, Vila Miravet, Víctor, García-Puig, Roger, La Orden-Izquierdo, Enrique, Peña Quintana, Luis, Barrio Torres, Josefa, Medina Benítez, Enrique, Leis, Rosaura, García-Romero, Ruth, Fernández de Valderrama, Ana, Vecino López, Raquel, Donado Palencia, Paloma, Beltrán, Marina Alvarez, Reyes-Domínguez, Ana Isabel, Colomé-Rivero, Gemma, Manchón, Silvia Rodríguez, Martinón, Nazareth, and Fernández-Caamaño, Beatriz

Published
2023
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23. Recomendaciones para el diagnóstico y manejo práctico de la esofagitis eosinofílica pediátrica

Author

Gutiérrez Junquera, Carolina, primary, Fernández Fernández, Sonia, additional, Domínguez-Ortega, Gloria, additional, Vila Miravet, Víctor, additional, García Puig, Roger, additional, García Romero, Ruth, additional, Fernández de Valderrama, Ana, additional, Andradas Rivas, Rebeca, additional, Alonso Vicente, Carmen, additional, Álvarez Beltrán, Marina, additional, Barrio Torres, Josefa, additional, Barros García, Patricia, additional, Colomé Rivero, Gemma, additional, Javier Eizaguirre Arocena, Francisco, additional, Fernández Caamaño, Beatriz, additional, Orden Izquierdo, Enrique la, additional, Leis Trabazo, Rosaura, additional, Lorenzo Garrido, Helena, additional, Medina Benítez, Enrique, additional, Montraveta Querol, Montserrat, additional, and Vecino López, Raquel, additional

Published
2020
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24. Recommendations for the diagnosis and practical management of paediatric eosinophilic oesophagitis

Author

Gutiérrez Junquera, Carolina, primary, Fernández Fernández, Sonia, additional, Domínguez-Ortega, Gloria, additional, Vila Miravet, Víctor, additional, García Puig, Roger, additional, García Romero, Ruth, additional, Fernández de Valderrama, Ana, additional, Andradas Rivas, Rebeca, additional, Alonso Vicente, Carmen, additional, Álvarez Beltrán, Marina, additional, Barrio Torres, Josefa, additional, Barros García, Patricia, additional, Colomé Rivero, Gemma, additional, Javier Eizaguirre Arocena, Francisco, additional, Fernández Caamaño, Beatriz, additional, Orden Izquierdo, Enrique la, additional, Leis Trabazo, Rosaura, additional, Lorenzo Garrido, Helena, additional, Medina Benítez, Enrique, additional, Montraveta Querol, Montserrat, additional, and Vecino López, Raquel, additional

Published
2020
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25. Rising trend in p​ediatric eosinophilic esophagitis incidence in Spain: Results of a prospective study 2014–16.

Author

La Orden Izquierdo, Enrique, Mahillo‐Fernández, Ignacio, Fernández Fernández, Sonia, Barrio Torres, Josefa, Román Riechmann, Enriqueta, Gutiérrez Junquera, Carolina, Santos, Alexandra, Cilleruelo Pascual, ML, Rayo Fernández, AI, Martínez Escribano, B, Botija Arcos, G, Barrio Merino, A, Urruzuno Tellería, P, Medina Benítez, E, Salcedo Lobato, E, Grande Herrero, L, Miranda Cid, C, Rodrigo García, G, Herrero Álvarez, M, and Carabaño Aguado, I

Subjects
LONGITUDINAL method, AIR pollutants, SYMPTOMS, DIAGNOSIS, EOSINOPHILIC esophagitis, MEDICAL consultation, DEGLUTITION disorders
Abstract

Objectives: The rate of eosinophilic esophagitis (EoE) diagnosis is increasing. This study aims to determine the incidence of EoE in the pediatric population residing in the southwestern Madrid and to analyze whether absolute monthly pollen counts, modified or not by the principal atmospheric pollutants, are associated with it. Methods: A cross‐sectional study on prospectively recruited patients was designed to calculate the incidence of EoE in children aged under 15 years who were diagnosed between September 2014 and August 2016 in twelve hospitals. We collected demographic and symptoms data, date of onset of symptoms, date of medical consultation, and date of endoscopic diagnosis of each included patient. Relative risk estimation was performed to assess the association between the incidence of diagnosis and monthly pollen counts and levels of atmospheric pollutants. All these models were adjusted for the number of total patients that underwent endoscopy at first time. Results: One hundred forty‐eight patients were included. The most frequent symptoms were abdominal pain [42.57%], dysphagia [42.57%], and impaction [39%–86%]. The median overall monthly incidence was 1.13 [interquartile rank: 0.97–1.43] cases/100,000 children, and the annual mean was 15.2. The overall analysis of the relationship between incidence and absolute monthly counts, corrected for the number of first‐time endoscopies performed, revealed no statistically significant association with pollen and air pollutants. There was a higher frequency of diagnosis during the pollination period of Cupressaceae [relative risk 1.647; 95% CI (1.192–2.276) p <.002] and during February and November (relative risk 1.67; p <.01). Conclusions: This study confirms the high incidence of eosinophilic esophagitis and also suggests a period of higher incidence of diagnosis in the months of February and November as well as in the period of high pollination of Cupressaceae. [ABSTRACT FROM AUTHOR]

Published
2021
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26. Proton-pump Inhibitor Response Prediction Using Esophageal microRNAs in Children With Eosinophilic Esophagitis.

Author

Cañas, José Antonio, Tabares, Ana, Barbero, Claudia, García-Sánchez, Daniel, Sastre, Beatriz, Rodrigo-Muñoz, José Manuel, Mahíllo-Fernández, Ignacio, Rayo, Ana, Borrell, Belén, Cilleruelo, Mª Luz, Román, Enriqueta, Fernandez-Fernandez, Sonia, Gutiérrez-Junquera, Carolina, del Pozo, Victoria, and Fernández-Fernández, Sonia

Published
2020
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28. Seguimiento de una cohorte de población infantil genéticamente predispuesta (HLA-DQ2) para la enfermedad celiaca: influencia de factores ambientales en el desarrollo de la enfermedad

Author

Fernández Fernández, Sonia, Cilleruelo Pascual, Mª Luz, and Ruiz Contreras, Jesús

Subjects
Medicina interna, Dietética y nutrición
Abstract

Presentamos un estudio de despistaje de enfermedad celiaca en población genéticamente predispuesta, así como una valoración de los posibles factores ambientales que intervienen en el desarrollo de la misma. En nuestra serie, el 10 por ciento de los niños de 2 a 3 años de edad portadores del haplotipo HLA-DQ2 presentaron autoinmunidad celíaca. La prevalencia de enfermedad celíaca confirmada en esta cohorte de riesgo fue de 5,7 por ciento. La prevalencia estimada en la población general estudiada fue de 1,1 por ciento. El espectro clínico completo de la EC se caracterizó por síntomas digestivos con o sin anemia ferropénica en más de mitad de los pacientes, escasa ganancia ponderal sin síntomas digestivos en el 7 por ciento y fueron asintomáticos la tercera parte. En el grupo de despistaje, una tercera parte presentó distensión abdominal con o sin anemia ferropénica como signos y síntomas a considerar en esta población mayoritariamente asintomática. El aumento significativo del Z score de peso al año del tratamiento en el grupo de despistaje podría indicar que estos niños, a pesar de la ausencia de síntomas, se benefician de la retirada del gluten de su dieta. Debido al elevado porcentaje de autoinmunidad celíaca transitoria en nuestros pacientes podemos concluir que el estudio de despistaje de EC entre los 2 y 3 años de edad puede llevar a la realización de biopsias intestinales normales. La utilización de criterios más estrictos que requieran la positividad de ambos anticuerpos a títulos altos podría disminuir el número de biopsias normales en este tipo de estudio.Tras 6 años de seguimiento, los niños que presentaron tanto EC potencial como autoinmunidad celíaca se mantienen asintomáticos y con serología persistentemente negativa. Como en la mayoría de los estudios de despistaje, se constata, en nuestra serie, un mayor riesgo de EC en el género femenino. En nuestra cohorte, la coincidencia de la lactancia materna con la introducción del gluten parece conferir un efecto protector en el desarrollo de la enfermedad.

Published
2014

31. Seguimiento de una cohorte de población infantil genéticamente predispuesta (HLA-DQ2) para la enfermedad celiaca: influencia de factores ambientales en el desarrollo de la enfermedad

Author

Cilleruelo Pascual, Mª Luz, Ruiz Contreras, Jesús, Fernández Fernández, Sonia, Cilleruelo Pascual, Mª Luz, Ruiz Contreras, Jesús, and Fernández Fernández, Sonia

Abstract

Presentamos un estudio de despistaje de enfermedad celiaca en población genéticamente predispuesta, así como una valoración de los posibles factores ambientales que intervienen en el desarrollo de la misma. En nuestra serie, el 10 por ciento de los niños de 2 a 3 años de edad portadores del haplotipo HLA-DQ2 presentaron autoinmunidad celíaca. La prevalencia de enfermedad celíaca confirmada en esta cohorte de riesgo fue de 5,7 por ciento. La prevalencia estimada en la población general estudiada fue de 1,1 por ciento. El espectro clínico completo de la EC se caracterizó por síntomas digestivos con o sin anemia ferropénica en más de mitad de los pacientes, escasa ganancia ponderal sin síntomas digestivos en el 7 por ciento y fueron asintomáticos la tercera parte. En el grupo de despistaje, una tercera parte presentó distensión abdominal con o sin anemia ferropénica como signos y síntomas a considerar en esta población mayoritariamente asintomática. El aumento significativo del Z score de peso al año del tratamiento en el grupo de despistaje podría indicar que estos niños, a pesar de la ausencia de síntomas, se benefician de la retirada del gluten de su dieta. Debido al elevado porcentaje de autoinmunidad celíaca transitoria en nuestros pacientes podemos concluir que el estudio de despistaje de EC entre los 2 y 3 años de edad puede llevar a la realización de biopsias intestinales normales. La utilización de criterios más estrictos que requieran la positividad de ambos anticuerpos a títulos altos podría disminuir el número de biopsias normales en este tipo de estudio.Tras 6 años de seguimiento, los niños que presentaron tanto EC potencial como autoinmunidad celíaca se mantienen asintomáticos y con serología persistentemente negativa. Como en la mayoría de los estudios de despistaje, se constata, en nuestra serie, un mayor riesgo de EC en el género femenino. En nuestra cohorte, la coincidencia de la lactancia materna con la introducción del gluten parece conferir un efec

Published
2015

32. CYP2C19and STAT6Variants Influence the Outcome of Proton Pump Inhibitor Therapy in Pediatric Eosinophilic Esophagitis

Author

Mougey, Edward B., Williams, Andre, Coyne, Ashlan J. Kunz, Gutiérrez-Junquera, Carolina, Fernández-Fernández, Sonia, Cilleruelo, Maria Luz, Rayo, Ana, Echeverría, Luis, Román, Enriqueta, González Lois, Carmen, Chao, Montserrat, Al-Atrash, Hadeel, Lima, John J., and Franciosi, James P.

Abstract

Proton pump inhibitors (PPIs) are an effective treatment for eosinophilic esophagitis (EoE); however, only 30% to 60% of patients respond. Common genetic variants in CYP2C19and STAT6associate with PPI plasma concentration and magnitude of inflammatory response, respectively. Our objective was to determine if genetic variation in the genes for CYP2C19and STAT6influence differentiation between PPI responsive esophageal eosinophilia versus PPI nonresponsive EoE (PPI-REE, PPI-nonresponsive EoE). Genomic DNA was isolated from 92 esophageal tissue biopsies collected from participants of a prospective clinical trial of high-dose PPI therapy for esophageal eosinophilia in children. Of the 92 patients examined, 57 (62%) were PPI-REE and 35 (38%) were PPI-nonresponsive EoE. Forty-six of the 92 patients were further characterized by pH probe monitoring; there was no association between reflux index and carriage of CYP2C19*17(P= 0.35). In children who received a PPI dose between =1.54 and ?2.05 mg/kg/day, binary logistic regression modeling showed that carriage of CYP2C19*17associated with PPI-nonresponsive EoE (odds ratio (OR) [95% confidence interval (CI)] = 7.71 [1.21, 49.11], P= 0.031). Carriage of STAT6allelic variant rs1059513 predicts PPI-REE (OR [95% CI] = 6.16 [1.44, 26.4], P= 0.028), whereas carriage of STAT6rs324011 synergizes with CYP2C19*17to predict PPI-nonresponsive EoE (rs324011 OR [95% CI] = 5.56 [1.33, 20.72], P= 0.022; CYP2C19*17OR [95% CI] = 8.19[1.42, 50.57], P= 0.023). Common variants in CYP2C19and STAT6associate with a PPI-nonresponsive EoE outcome of PPI therapy for esophageal eosinophilia suggesting that response rates may be improved by adopting a genotype-guided approach to PPI dosing.

Published
2019
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34. Aplicabilidad de los microarns y otros mediadores (proteicos y lipídicos) como biomarcadores en la esofagitis eosinofílica. Utilidad para el diagnóstico y valoración de la respuesta al tratamiento

Author

Tabares González, Ana, Fernández Fernández, Sonia, Gutiérrez Junquera, Carolina, Del Pozo Abejón, Victoria, Universidad de Alcalá. Departamento de Biología de Sistemas, and Universidad de Alcalá. Programa de Doctorado en Ciencias de la Salud

Subjects
Medicina, Pediatría, Medicine
Abstract

La Esofagitis Eosinofílica (EoE) es una enfermedad crónica del esófago, de base inmunológica, caracterizada clínicamente por síntomas de disfunción esofágica e histológicamente por un infiltrado inflamatorio con predominio de eosinófilos. Los inhibidores de la bomba de protones (IBP) constituyen un tratamiento de primera línea en la EoE, con una alta tasa de remisión clínico-histológica, aunque hasta el momento no se han identificado factores predictivos de respuesta. El objetivo principal del presente estudio es determinar el perfil de mediadores (proteicos y lipídicos) y microARNs en la mucosa esofágica y en el suero de pacientes pediátricos con EoE al diagnóstico y tras tratamiento con IBP, con el fin de hallar marcadores moleculares de la actividad inflamatoria en estos pacientes y posibles factores predictivos de respuesta al tratamiento con IBP. Se realizó un estudio observacional prospectivo caso-control con pacientes pediátricos entre 1-15 años procedentes de dos hospitales. Los casos seleccionados fueron tratados con esomeprazol 1 mg/kg/dosis dos veces al día durante 8-12 semanas y se realizó una segunda endoscopia (EDA) con toma de biopsias. La remisión histológica (IBP-R) fue definida como el aislamiento de

Published
2022

35. Sex-related differences in the presentation, management and response to treatment of eosinophilic esophagitis: Cross sectional analysis of EoE CONNECT registry.

Author

Laserna-Mendieta EJ, Casabona-Francés S, Amorena E, Savarino EV, Pérez-Martínez I, Blas-Jhon L, Guardiola-Arévalo A, Coletta M, Pellegatta G, Guagnozzi D, Barrio J, Perello A, Betoré E, Krarup AL, Votto M, Gutiérrez-Junquera C, Naves JE, Oliva S, Teruel Sánchez-Vegazo C, Carrión S, Riva S, Espina-Cadenas S, Fernández-Fernández S, Llorente-Barrio M, Pascual-Lopez I, Masiques-Mas ML, Honrubia-López R, Dainese R, García-Morales N, Cobian J, Bisso-Zein JK, Roales V, Juan-Juan A, Rodríguez-Sánchez A, Feo-Ortega S, Martín-Domínguez V, Nantes-Castillejo Ó, Nicolay-Maneru J, Ghisa M, Maniero D, Suarez A, Maray I, Álvarez-García M, Granja-Navacerrada A, Penagini R, Racca F, Llerena-Castro R, Santander C, Arias Á, and Lucendo AJ

Abstract

Background: Eosinophilic esophagitis (EoE) predominantly affects males across all ages; however, little is known about sex differences for other aspects of EoE., Objective: To investigate associations between sex and clinical presentation, endoscopic features, treatment choice and response in EoE patients in real-world practice., Methods: Cross-sectional analysis of the multicenter EoE CONNECT registry. The independent contribution of patients' sex and other relevant variables were statistically assessed by multivariate models., Results: A total of 2976 patients (76% male) were evaluated. Males were diagnosed at a younger age compared to females (32.7 ± 14.8 vs. 34.8 ± 15.6 years, respectively; p = 0.002) with similar diagnostic delay. EoE symptoms varied significantly between sexes, with food impaction predominating in males and dysphagia, heartburn, regurgitation and abdominal and epigastric pain in females. However, female sex contributed to higher symptom severity at diagnosis as measured with Dysphagia Symptom Score (R 2  = 0.57; p = 0.013) and presented higher peak eosinophil count in esophageal biopsies (p = 0.005). Males showed increased risk of stricturing or mixed phenotypes (adjusted OR 1.43, 95%CI:1.05-1.96; p = 0.024). No association was found between patients' sex and first-line treatment modality: proton pump inhibitors (PPI) were preferred over topical corticosteroids in patients with inflammatory phenotypes instead of stricturing or mixed phenotypes, and in patients who did not present food impaction. Both topical corticosteroids and dietary interventions were preferred over PPI in pediatric patients regardless of sex., Conclusions: Sex is associated with clinical and phenotypical presentation of EoE at diagnosis, with more fibrotic findings in males but higher symptom score in females., (© 2024 The Author(s). United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)

Published
2024
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