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1. A MULTICENTER LONG-TERM COHORT STUDY OF EOSINOPHILIC ESOPHAGITIS VARIANTS AND THEIR PROGRESSION TO EOE OVER TIME

Author

Greuter, Thomas, Straumann, Alex, Fernandez-Marrero, Yuniel, Germic, Nina, Hosseini, Aref, Chanwangpong, Apinya, Yousefi, Shida, Simon, Dagmar, Collins, Margaret H., Bussmann, Christian, Chehade, Mirna, Dellon, Evan S., Furuta, Glenn T., Gonsalves, Nirmala, Hirano, Ikuo, Moawad, Fouad J., Biedermann, Luc, Safroneeva, Ekaterina, Schoepfer, Alain M., and Simon, Hans-Uwe

Published
2024
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4. A Multicenter Long-Term Cohort Study of Eosinophilic Esophagitis Variants and Their Progression to Eosinophilic Esophagitis Over Time

Author

Greuter, Thomas, Straumann, Alex, Fernandez-Marrero, Yuniel, Germic, Nina, Hosseini, Aref, Chanwangpong, Apinya, Yousefi, Shida, Simon, Dagmar, Collins, Margaret H., Bussmann, Christian, Chehade, Mirna, Dellon, Evan S., Furuta, Glenn T., Gonsalves, Nirmala, Hirano, Ikuo, Moawad, Fouad J., Biedermann, Luc, Safroneeva, Ekaterina, Schoepfer, Alain M., and Simon, Hans-Uwe

Published
2024
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7. Variation in Endoscopic Activity Assessment and Endoscopy Score Validation in Adults With Eosinophilic Esophagitis

Author

Schoepfer, Alain M, Hirano, Ikuo, Coslovsky, Michael, Roumet, Marie C, Zwahlen, Marcel, Kuehni, Claudia E, Hafner, David, Alexander, Jeffrey A, Dellon, Evan S, Gonsalves, Nirmala, Leung, John, Bussmann, Christian, Collins, Margaret H, Newbury, Robert O, Smyrk, Thomas C, Woosley, John T, Yang, Guang-Yu, Romero, Yvonne, Katzka, David A, Furuta, Glenn T, Gupta, Sandeep K, Aceves, Seema S, Chehade, Mirna, Spergel, Jonathan M, Falk, Gary W, Meltzer, Brian A, Comer, Gail M, Straumann, Alex, Safroneeva, Ekaterina, Group, International EEsAI Study, Achem, Sami R, Arora, Amindra S, Alpan, Oral, Armstrong, David, Attwood, Stephen E, Butterfield, Joseph H, Crowell, Michael D, DeVault, Kenneth R, Drouin, Eric, Enav, Benjamin, Enders, Felicity T, Fleischer, David E, Foxx-Orenstein, Amy, Francis, Dawn L, Guyatt, Gordon H, Harris, Lucinda A, Kagalwalla, Amir F, Kita, Hirohito, Krishna, Murli, Lee, James J, Lewis, John C, Lim, Kaiser, Locke, G Richard, Murray, Joseph A, Nguyen, Cuong C, Orbelo, Diana M, Pasha, Shabana F, Ramirez, Francisco C, Sheikh, Javed, Umar, Sarah B, Weiler, Catherine R, Wo, John M, Wu, Tsung-Teh, and Yost, Kathleen J

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Digestive Diseases, Clinical Research, Clinical Trials and Supportive Activities, Prevention, Adolescent, Adult, Aged, Anti-Inflammatory Agents, Dose-Response Relationship, Drug, Eosinophilic Esophagitis, Esophagoscopy, Esophagus, Female, Fluticasone, Humans, Male, Middle Aged, Prognosis, Severity of Illness Index, Young Adult, Index, Variability in Endoscopic Assessment, Instrument, International EEsAI Study Group, Gastroenterology & Hepatology, Clinical sciences
Abstract

Background & aimsEosinophilic esophagitis (EoE) is assessed endoscopically (endoscopic activity), based on grades of edema, rings, exudates, furrows, and strictures (EREFS). We examined variations in endoscopic assessments of severity, developed and validated 3 EREFS-based scoring systems, and assessed responsiveness of these systems using data from a randomized placebo-controlled trial of patients with EoE.MethodsFor the development set, 5 gastroenterologists reviewed EREFS findings from 266 adults with EoE and provided endoscopist global assessment scores (EndoGA, scale of 0 to 10); variation (ΔEndoGA) was assessed using linear regression. We evaluated simple scores (features given arbitrary values from 0 to 3) and developed 2 scoring systems (adjusted score range, 0-100). We then fitted our linear regression model with mean EndoGA to data from 146 adults recruited in centers in Switzerland and the United States between April 2011 and December 2012. For the validation set, we collected data from 120 separate adults (recruited in centers in Switzerland and the United States between May 2013 and July 2014), assessing regression coefficient-based scores using Bland-Altman method. We assessed the responsiveness of our scoring systems using data from a randomized trial of patients with EoE given fluticasone (n=16) or placebo (n=8).ResultsThe distribution of EndoGA values differed among endoscopists (mean ΔEndoGA, 2.6±1.8; range 0-6.6). We developed 2 regression-based scoring systems to assess overall and proximal and distal esophageal findings; variation in endoscopic features accounted for more than 90% of the mean EndoGA variation. In the validation group, differences between mean EndoGA and regression-based scores were small (ranging from -4.70 to 2.03), indicating good agreement. In analyses of data from the randomized trial, the baseline to end of study change in patients given fluticasone was a reduction of 24.3 in simple score (reduction of 4.6 in patients given placebo, P=.052); a reduction of 23.5 in regression-based overall score (reduction of 6.56 in patients given placebo, P=.12), and a reduction of 23.8 (reduction of 8.44 in patients given placebo, P=.11).ConclusionAssessments of endoscopic activity in patients with EoE vary among endoscopists. In an analysis of data from a randomized controlled trial, we found that newly developed scoring systems are no better than simple scoring system in detecting changes in endoscopic activity. These results support the use of a simple scoring system in evaluation of endoscopic activity in patients with EoE. clinicaltrials.gov no: NCT00939263 and NCT01386112.

Published
2019

8. Heterogeneity in Clinical, Endoscopic, and Histologic Outcome Measures and Placebo Response Rates in Clinical Trials of Eosinophilic Esophagitis: A Systematic Review

Author

Ma, Christopher, van Rhijn, Bram D, Jairath, Vipul, Nguyen, Tran M, Parker, Claire E, Aceves, Seema S, Furuta, Glenn T, Gupta, Sandeep K, Katzka, David A, Safroneeva, Ekaterina, Schoepfer, Alain M, Straumann, Alex, Spergel, Jonathan M, Pai, Rish K, Feagan, Brian G, Hirano, Ikuo, Dellon, Evan S, and Bredenoord, Albert J

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Trials and Supportive Activities, Clinical Research, Cancer, Digestive Diseases, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Adolescent, Adult, Anti-Inflammatory Agents, Child, Eosinophilic Esophagitis, Esophagus, Female, Humans, Male, Outcome Assessment, Health Care, Placebos, Randomized Controlled Trials as Topic, Treatment Outcome, Young Adult, Inflammation, Drug, Endoscopy, Histology, Patient-Reported Outcomes, Placebo, Gastroenterology & Hepatology, Clinical sciences
Abstract

Background & aimsAgents are being developed for treatment of eosinophilic esophagitis (EoE). However, it is not clear what outcome measures would best determine the efficacy and safety of these agents in clinical trials. We performed a systematic review of outcomes used in randomized placebo-controlled trials of EoE and we estimate the placebo response and rates of remission.MethodsWe searched MEDLINE, Embase, CENTRAL, ClinicalTrials.gov, and the EU Clinical Trials Register from inception through February 20, 2018 for randomized controlled trials of pharmacologic therapies for EoE. Efficacy outcome definitions, measurement tools, and the proportion of patients responding to placebo were collected and stratified by based on histologic, endoscopic, and patient-reported outcomes.ResultsWe analyzed data from 22 placebo-controlled trials, comprising 1112 patients with EoE. Ten additional active registered trials were identified. Most published trials evaluated topical corticosteroid therapy (13/22, 59.1%). Histologic outcomes measuring eosinophil density and patient-reported outcomes were reported in 21/22 published trials (95.5%). No consistently applied definitions of histologic or patient-reported response or remission were identified. Endoscopic outcomes were described in 60% (12/20) of published trials. The EoE Endoscopic Reference Score is the most commonly applied tool for describing changes in endoscopic appearance. The median histologic response to placebo was 3.7% (range, 0%-31.6%) and the median rate of remission in patients given placebo was 0.0% (range, 0%-11.0%). The median patient-reported response to placebo was 14.4% (range, 8.6%-77.8%) and rate of remission in patients given placebo was 26.2% (range, 13.2%-35.7%).ConclusionsIn a systematic review of the literature, we found that no standardized definitions of histologic, endoscopic, or patient-reported outcomes are used to determine whether pharmacologic agents produce a response or remission in patients with EoE. A core outcome set is needed to reduce heterogeneity in outcome reporting and facilitate trial interpretation and comparison of results from trials.

Published
2018

9. Long-Lasting Dissociation of Esophageal Eosinophilia and Symptoms After Dilation in Adults With Eosinophilic Esophagitis

Author

Safroneeva, Ekaterina, Pan, Zhaoxing, King, Eileen, Martin, Lisa J., Collins, Margaret H., Yang, Guang-Yu, Capocelli, Kelley E., Arva, Nicoleta C., Abonia, J. Pablo, Atkins, Dan, Bonis, Peter A., Dellon, Evan S., Falk, Gary W., Gonsalves, Nirmala, Gupta, Sandeep K., Hirano, Ikuo, Leung, John, Menard-Katcher, Paul A., Mukkada, Vincent A., Schoepfer, Alain M., Spergel, Jonathan M., Wershil, Barry K., Rothenberg, Marc E., Aceves, Seema S., and Furuta, Glenn T.

Published
2022
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10. Effectiveness and Safety of High- vs Low-Dose Swallowed Topical Steroids for Maintenance Treatment of Eosinophilic Esophagitis: A Multicenter Observational Study

Author

Greuter, Thomas, Godat, Anne, Ringel, Amit, Almonte, Hector Samuel, Schupack, Daniel, Mendoza, Gabriela, McCright-Gill, Talaya, Dellon, Evan S., Hirano, Ikuo, Alexander, Jeffrey, Chehade, Mirna, Safroneeva, Ekaterina, Bussmann, Christian, Biedermann, Luc, Schreiner, Philipp, Schoepfer, Alain M., Straumann, Alex, and Katzka, David A.

Published
2021
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11. Pediatric Patients with Eosinophilic Esophagitis and Their Parents Identify Symptoms as the Most Important Treatment Outcome

Author

von Graffenried, Thea, primary, Safroneeva, Ekaterina, additional, Braegger, Christian, additional, Ezri, Jessica, additional, Garzoni, Luca, additional, Giroud Rivier, Alexa, additional, Greuter, Thomas, additional, Köhler, Henrik, additional, McLin, Valerie A., additional, Marx, George, additional, Müller, Pascal, additional, Petit, Laetitia Marie, additional, Schibli, Susanne, additional, Sokollik, Christiane, additional, Tempia-Caliera, Michela, additional, Zwahlen, Marcel, additional, Schoepfer, Alain M., additional, and Nydegger, Andreas, additional

Published
2024
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12. Impact of Overweight and Obesity on Disease Outcome in the Pediatric Swiss Inflammatory Bowel Disease Cohort

Author

von Graffenried, Thea, Schoepfer, Alain M., Rossel, Jean-Benoit, Greuter, Thomas, Safroneeva, Ekaterina, Godat, Sébastien, Henchoz, Sarah, Vavricka, Stephan R., Sokollik, Christiane, Spalinger, Johannes, Braegger, Christian P., Nydegger, Andreas, Abdelrahman, Karim, Ademi, Gentiana, Aepli, Patrick, Thomas, Amman, Anderegg, Claudia, Antonino, Anca-Teodora, Archanioti, Eva, Arrigoni, Eviano, de Jong, Diana Bakker, Balsiger, Bruno, Bastürk, Polat, Bauerfeind, Peter, Becocci, Andrea, Belli, Dominique, Bengoa, José M., Biedermann, Luc, Binek, Janek, Blattmann, Mirjam, Boehm, Stephan, Boldanova, Tujana, Borovicka, Jan, Braegger, Christian P., Brand, Stephan, Brügger, Lukas, Brunner, Simon, Bühr, Patrick, Burnand, Bernard, Burk, Sabine, Burri, Emanuel, Buyse, Sophie, Cao, Dahlia-Thao, Carstens, Ove, Criblez, Dominique H., Cunningham, Sophie, D’Angelo, Fabrizia, de Saussure, Philippe, Degen, Lukas, Delarive, Joakim, Doerig, Christopher, Dora, Barbara, Drerup, Susan, Egger, Mara, El-Wafa, Ali, Engelmann, Matthias, Felley, Christian, Fliegner, Markus, Fournier, Nicolas, Fraga, Montserrat, Franc, Yannick, Frei, Pascal, Frei, Remus, Fried, Michael, Froehlich, Florian, Furlano, Raoul Ivano, Garzoni, Luca, Geyer, Martin, Girard, Laurent, Girardin, Marc, Golay, Delphine, Good, Ignaz, Bigler, Ulrike Graf, Gysi, Beat, Haarer, Johannes, Halama, Marcel, Haldemann, Janine, Heer, Pius, Heimgartner, Benjamin, Helbling, Beat, Hengstler, Peter, Herzog, Denise, Hess, Cyrill, Heyland, Klaas, Hinterleitner, Thomas, Hirschi, Claudia, Hruz, Petr, Juillerat, Pascal, Khalid-de Bakker, Carolina, Kayser, Stephan, Keller, Céline, Knellwolf, Christina, Knoblauch, Christoph, Köhler, Henrik, Koller, Rebekka, Krieger, Claudia, Künzler, Patrizia, Kusche, Rachel, Lehmann, Frank Serge, Macpherson, Andrew, Maillard, Michel H., Manz, Michael, Marot, Astrid, Meier, Rémy, Meyenberger, Christa, Meyer, Pamela, Michetti, Pierre, Misselwitz, Benjamin, Mosler, Patrick, Mottet, Christian, Müller, Christoph, Müllhaupt, Beat, Musso, Leilla, Neagu, Michaela, Nichita, Cristina, Niess, Jan, Nydegger, Andreas, Obialo, Nicole, Ollo, Diana, Oropesa, Cassandra, Peter, Ulrich, Peternac, Daniel, Petit, Laetitia Marie, Pittet, Valérie, Pohl, Daniel, Porzner, Marc, Preissler, Claudia, Raschle, Nadia, Rentsch, Ronald, Restellini, Alexandre, Restellini, Sophie, Richterich, Jean-Pierre, Ris, Frederic, Risti, Branislav, Ritz, Marc Alain, Rogler, Gerhard, Röhrich, Nina, Rossel, Jean-Benoît, Rueger, Vanessa, Rusticeanu, Monica, Sagmeister, Markus, Saner, Gaby, Sauter, Bernhard, Sawatzki, Mikael, Scharl, Michael, Schelling, Martin, Schibli, Susanne, Schlauri, Hugo, Schluckebier, Dominique, Schmid, Daniela, Schmid, Sybille, Schnegg, Jean-François, Schoepfer, Alain, Seematter, Vivianne, Seibold, Frank, Seirafi, Mariam, Semadeni, Gian-Marco, Senning, Arne, Sokollik, Christiane, Sommer, Joachim, Spalinger, Johannes, Spangenberger, Holger, Stadler, Philippe, Staub, Peter, Staudenmann, Dominic, Stenz, Volker, Steuerwald, Michael, Straumann, Alex, Stulz, Andreas, Sulz, Michael, Tatu, Aurora, Tempia-Caliera, Michela, Thorens, Joël, Truninger, Kaspar, Tutuian, Radu, Urfer, Patrick, Vavricka, Stephan, Viani, Francesco, Vögtlin, Jürg, Von Känel, Roland, Vouillamoz, Dominique, Vulliamy, Rachel, Wiesel, Paul, Wiest, Reiner, Wöhrle, Stefanie, Zamora, Samuel, Zander, Silvan, Zeitz, Jonas, and Zimmermann, Dorothee

Published
2022
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13. Symptoms Have Modest Accuracy in Detecting Endoscopic and Histologic Remission in Adults With Eosinophilic Esophagitis

Author

Safroneeva, Ekaterina, Straumann, Alex, Coslovsky, Michael, Zwahlen, Marcel, Kuehni, Claudia E, Panczak, Radoslaw, Haas, Nadine A, Alexander, Jeffrey A, Dellon, Evan S, Gonsalves, Nirmala, Hirano, Ikuo, Leung, John, Bussmann, Christian, Collins, Margaret H, Newbury, Robert O, De Petris, Giovanni, Smyrk, Thomas C, Woosley, John T, Yan, Pu, Yang, Guang-Yu, Romero, Yvonne, Katzka, David A, Furuta, Glenn T, Gupta, Sandeep K, Aceves, Seema S, Chehade, Mirna, Spergel, Jonathan M, Schoepfer, Alain M, Group, International Eosinophilic Esophagitis Activity Index Study, Achem, Sami R, Arora, Amindra S, Alpan, Oral, Armstrong, David, Attwood, Stephen E, Butterfield, Joseph H, Crowell, Michael D, DeVault, Kenneth R, Drouin, Eric, Enav, Benjamin, Enders, Felicity T, Fleischer, David E, Foxx-Orenstein, Amy, Francis, Dawn L, Guyatt, Gordon H, Harris, Lucinda A, Kagalwalla, Amir F, Kita, Hirohito, Krishna, Murli, Lee, James J, Lewis, John C, Lim, Kaiser, Locke, G Richard, Murray, Joseph A, Nguyen, Cuong C, Orbelo, Diana M, Pasha, Shabana F, Ramirez, Francisco C, Sheikh, Javed, Umar, Sarah B, Weiler, Catherine R, Wo, John M, Wu, Tsung-Teh, and Yost, Kathleen J

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Digestive Diseases, Cancer, Clinical Research, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Adolescent, Adult, Aged, Aged, 80 and over, Area Under Curve, Biopsy, Eosinophilic Esophagitis, Eosinophils, Esophagoscopy, Female, Humans, Leukocyte Count, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, ROC Curve, Remission Induction, Reproducibility of Results, Severity of Illness Index, Surveys and Questionnaires, Switzerland, Treatment Outcome, United States, Young Adult, EEsAI, Remission, Endoscopic Grading, Disease Monitoring, International Eosinophilic Esophagitis Activity Index Study Group, Neurosciences, Paediatrics and Reproductive Medicine, Gastroenterology & Hepatology, Clinical sciences, Nutrition and dietetics
Abstract

Background & aimsIt is not clear whether symptoms alone can be used to estimate the biologic activity of eosinophilic esophagitis (EoE). We aimed to evaluate whether symptoms can be used to identify patients with endoscopic and histologic features of remission.MethodsBetween April 2011 and June 2014, we performed a prospective, observational study and recruited 269 consecutive adults with EoE (67% male; median age, 39 years old) in Switzerland and the United States. Patients first completed the validated symptom-based EoE activity index patient-reported outcome instrument and then underwent esophagogastroduodenoscopy with esophageal biopsy collection. Endoscopic and histologic findings were evaluated with a validated grading system and standardized instrument, respectively. Clinical remission was defined as symptom score

Published
2016

14. Development and Validation of a Symptom-Based Activity Index for Adults With Eosinophilic Esophagitis

Author

Schoepfer, Alain M, Straumann, Alex, Panczak, Radoslaw, Coslovsky, Michael, Kuehni, Claudia E, Maurer, Elisabeth, Haas, Nadine A, Romero, Yvonne, Hirano, Ikuo, Alexander, Jeffrey A, Gonsalves, Nirmala, Furuta, Glenn T, Dellon, Evan S, Leung, John, Collins, Margaret H, Bussmann, Christian, Netzer, Peter, Gupta, Sandeep K, Aceves, Seema S, Chehade, Mirna, Moawad, Fouad J, Enders, Felicity T, Yost, Kathleen J, Taft, Tiffany H, Kern, Emily, Zwahlen, Marcel, Safroneeva, Ekaterina, and Group, International Eosinophilic Esophagitis Activity Index Study

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Digestive Diseases, Clinical Research, Food Allergies, Adaptation, Psychological, Adult, Deglutition Disorders, Endoscopy, Gastrointestinal, Eosinophilic Esophagitis, Feeding Behavior, Female, Humans, Linear Models, Male, Reproducibility of Results, Self Report, Severity of Illness Index, Surveys and Questionnaires, Switzerland, United States, Disease Activity Measurement, Esophagus, Patient-Reported Outcome, Marker, International Eosinophilic Esophagitis Activity Index Study Group, Neurosciences, Paediatrics and Reproductive Medicine, Gastroenterology & Hepatology, Clinical sciences, Nutrition and dietetics
Abstract

Background & aimsStandardized instruments are needed to assess the activity of eosinophilic esophagitis (EoE) and to provide end points for clinical trials and observational studies. We aimed to develop and validate a patient-reported outcome (PRO) instrument and score, based on items that could account for variations in patient assessments of disease severity. We also evaluated relationships between patient assessment of disease severity and EoE-associated endoscopic, histologic, and laboratory findings.MethodsWe collected information from 186 patients with EoE in Switzerland and the United States (69.4% male; median age, 43 y) via surveys (n = 135), focus groups (n = 27), and semistructured interviews (n = 24). Items were generated for the instruments to assess biologic activity based on physician input. Linear regression was used to quantify the extent to which variations in patient-reported disease characteristics could account for variations in patient assessment of EoE severity. The PRO instrument was used prospectively in 153 adult patients with EoE (72.5% male; median age, 38 y), and validated in an independent group of 120 patients with EoE (60.8% male; median age, 40.5 y).ResultsSeven PRO factors that are used to assess characteristics of dysphagia, behavioral adaptations to living with dysphagia, and pain while swallowing accounted for 67% of the variation in patient assessment of disease severity. Based on statistical consideration and patient input, a 7-day recall period was selected. Highly active EoE, based on endoscopic and histologic findings, was associated with an increase in patient-assessed disease severity. In the validation study, the mean difference between patient assessment of EoE severity (range, 0-10) and PRO score (range, 0-8.52) was 0.15.ConclusionsWe developed and validated an EoE scoring system based on 7 PRO items that assess symptoms over a 7-day recall period. Clinicaltrials.gov number: NCT00939263.

Published
2014

15. Variation in Endoscopic Activity Assessment and Endoscopy Score Validation in Adults With Eosinophilic Esophagitis

Author

Achem, Sami R., Arora, Amindra S., Alpan, Oral, Armstrong, David, Attwood, Stephen E., Butterfield, Joseph H., Crowell, Michael D., DeVault, Kenneth R., Drouin, Eric, Enav, Benjamin, Enders, Felicity T., Fleischer, David E., Foxx-Orenstein, Amy, Francis, Dawn L., Guyatt, Gordon H., Harris, Lucinda A., Kagalwalla, Amir F., Kita, Hirohito, Krishna, Murli, Lee, James J., Lewis, John C., Lim, Kaiser, Locke, G. Richard, III, Murray, Joseph A., Nguyen, Cuong C., Orbelo, Diana M., Pasha, Shabana F., Ramirez, Francisco C., Sheikh, Javed, Umar, Sarah B., Weiler, Catherine R., Wo, John M., Wu, Tsung-Teh, Yost, Kathleen J., Schoepfer, Alain M., Hirano, Ikuo, Coslovsky, Michael, Roumet, Marie C., Zwahlen, Marcel, Kuehni, Claudia E., Hafner, David, Alexander, Jeffrey A., Dellon, Evan S., Gonsalves, Nirmala, Leung, John, Bussmann, Christian, Collins, Margaret H., Newbury, Robert O., Smyrk, Thomas C., Woosley, John T., Yang, Guang-Yu, Romero, Yvonne, Katzka, David A., Furuta, Glenn T., Gupta, Sandeep K., Aceves, Seema S., Chehade, Mirna, Spergel, Jonathan M., Falk, Gary W., Meltzer, Brian A., Comer, Gail M., Straumann, Alex, and Safroneeva, Ekaterina

Published
2019
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17. RPC4046, a Monoclonal Antibody Against IL13, Reduces Histologic and Endoscopic Activity in Patients With Eosinophilic Esophagitis

Author

Hirano, Ikuo, Collins, Margaret H., Assouline-Dayan, Yehudith, Evans, Larry, Gupta, Sandeep, Schoepfer, Alain M., Straumann, Alex, Safroneeva, Ekaterina, Grimm, Michael, Smith, Heather, Tompkins, Cindy-ann, Woo, Amy, Peach, Robert, Frohna, Paul, Gujrathi, Sheila, Penenberg, Darryl N., Li, Caiyan, Opiteck, Gregory J., Olson, Allan, Aranda, Richard, Rothenberg, Marc E., and Dellon, Evan S.

Published
2019
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23. A Summary of the Meetings of the Development of a Core Outcome Set for Therapeutic Studies in Eosinophilic Esophagitis (COREOS) International Multidisciplinary Consensus

Author

Ma, Christopher, Schoepfer, Alain M., Safroneeva, Ekaterina, Dellon, Evan S., Bredenoord, Albert J., Chehade, Mirna, Collins, Margaret H., Feagan, Brian G., Furuta, Glenn T., Gupta, Sandeep K., Hirano, Ikuo, Jairath, Vipul, Katzka, David A., Pai, Rish K., Rothenberg, Marc E., Straumann, Alex, Aceves, Seema S., Alexander, Jeffrey A., Arva, Nicoleta C., Atkins, Dan, Biedermann, Luc, Blanchard, Carine, Cianferoni, Antonella, Ciriza de los Rios, Constanza, Clayton, Frederic, Davis, Carla M., de Bortoli, Nicola, Dias, Jorge A., Falk, Gary W., Genta, Robert M., Ghaffari, Gisoo, Gonsalves, Nirmala, Greuter, Thomas, Hopp, Russell, Hsu Blatman, Karen S., Jensen, Elizabeth T., Johnston, Doug, Kagalwalla, Amir F., Larsson, Helen M., Leung, John, Louis, Hubert, Masterson, Joanne C., Menard-Katcher, Calies, Menard-Katcher, Paul A., Moawad, Fouad J., Muir, Amanda B., Mukkada, Vincent A., Penagini, Roberto, Pesek, Robert D., Peterson, Kathryn, Putnam, Philip E., Ravelli, Alberto, Savarino, Edoardo V., Schlag, Christoph, Schreiner, Philipp, Simon, Dagmar, Smyrk, Thomas C., Spergel, Jonathan M., Taft, Tiffany H., Terreehorst, Ingrid, Vanuytsel, Tim, Venter, Carina, Vieira, Mario C., Vieth, Michael, Vlieg-Boerstra, Berber, von Arnim, Ulrike, Walker, Marjorie M., Wechsler, Joshua B., Woodland, Philip, Woosley, John T., Yang, Guang-Yu, Zevit, Noam, Ma, Christopher, Schoepfer, Alain M., Safroneeva, Ekaterina, Dellon, Evan S., Bredenoord, Albert J., Chehade, Mirna, Collins, Margaret H., Feagan, Brian G., Furuta, Glenn T., Gupta, Sandeep K., Hirano, Ikuo, Jairath, Vipul, Katzka, David A., Pai, Rish K., Rothenberg, Marc E., Straumann, Alex, Aceves, Seema S., Alexander, Jeffrey A., Arva, Nicoleta C., Atkins, Dan, Biedermann, Luc, Blanchard, Carine, Cianferoni, Antonella, Ciriza de los Rios, Constanza, Clayton, Frederic, Davis, Carla M., de Bortoli, Nicola, Dias, Jorge A., Falk, Gary W., Genta, Robert M., Ghaffari, Gisoo, Gonsalves, Nirmala, Greuter, Thomas, Hopp, Russell, Hsu Blatman, Karen S., Jensen, Elizabeth T., Johnston, Doug, Kagalwalla, Amir F., Larsson, Helen M., Leung, John, Louis, Hubert, Masterson, Joanne C., Menard-Katcher, Calies, Menard-Katcher, Paul A., Moawad, Fouad J., Muir, Amanda B., Mukkada, Vincent A., Penagini, Roberto, Pesek, Robert D., Peterson, Kathryn, Putnam, Philip E., Ravelli, Alberto, Savarino, Edoardo V., Schlag, Christoph, Schreiner, Philipp, Simon, Dagmar, Smyrk, Thomas C., Spergel, Jonathan M., Taft, Tiffany H., Terreehorst, Ingrid, Vanuytsel, Tim, Venter, Carina, Vieira, Mario C., Vieth, Michael, Vlieg-Boerstra, Berber, von Arnim, Ulrike, Walker, Marjorie M., Wechsler, Joshua B., Woodland, Philip, Woosley, John T., Yang, Guang-Yu, and Zevit, Noam

Abstract

The Core Outcome Set for Therapeutic Studies in Eosinophilic Esophagitis (COREOS) collaborators are a group of more than 70 gastroenterologists, pathologists, allergists, researchers, dietitians, psychologists, and methodologists who convened in a series of in-person and virtual meetings between 2018 and 2020 with the aim of developing a core outcome set (COS) for use in therapeutic studies of pharmacologic and dietary therapies for the treatment of eosinophilic esophagitis (EoE). Given heterogeneity in reported outcomes and uncertainties regarding the most appropriate end points for use in both randomized controlled trials (RCTs) and observational studies involving EoE patients, the EoE experts launched the COREOS exercise in 2018 to standardize outcome definitions using methods established by the Core Outcome Measures in Effectiveness Trials (COMET) initiative.1,2 The COS was developed using a multiphase approach, which is summarized in Figure 1. In the first phase, systematic reviews of the literature and patient engagement surveys were conducted to identify candidate outcomes that have been previously measured and are important to patients with EoE. Next, this information was used to build a framework of different outcome domains, and working groups for each domain were assembled to review the literature for relevant end points.3–6 The relative importance of these domains was categorized in a Delphi survey as core, important, and research agenda domains, and discussed in a moderated in-person meeting on May 17, 2019 at Digestive Disease Week (San Diego, CA). In phase 3, a comprehensive list of outcome measures within each of the core domains was evaluated by the COREOS collaborators in a 2-round Delphi survey and, finally, outcomes were ratified in a virtual meeting on December 8, 2020. In this meeting summary, we highlight the major points of discussion that occurred during the development of the EoE COS.

Published
2021

24. Histological Phenotyping in Eosinophilic Esophagitis: Localized Proximal Disease Is Infrequent but Associated with Less Severe Disease and Better Disease Outcome.

Author

Heil, Alexis, Kuehlewindt, Tobias, Godat, Anne, Simon, Hans-Uwe, Simon, Dagmar, Schreiner, Philipp, Saner, Catherine, Vavricka, Stephan R., Biedermann, Luc, Safroneeva, Ekaterina, Rossel, Jean-Benoit, Limacher, Andreas, Straumann, Alex, Schoepfer, Alain M., and Greuter, Thomas

Subjects
EOSINOPHILIC esophagitis, GASTROESOPHAGEAL reflux, SYMPTOMS, TREATMENT failure, EOSINOPHILIA, REGRESSION analysis
Abstract

Introduction: It is still unknown whether eosinophilic esophagitis (EoE) patients with localized disease are different from those with extended disease. Methods: We evaluated prospectively included patients in the Swiss EoE cohort. Data on all patients with active disease at baseline, no concomitant gastroesophageal reflux disease, no strictures at baseline, and at least one follow-up visit were analyzed. We compared patients with histologically localized proximal versus distal versus extended (=proximal and distal) disease with regard to patient, disease characteristics, disease presentation, and development of complications. Results: We included 124 patients with a median of 2.5 years of follow-up (73.4% males, median age 35.0 years). Ten patients had proximal (8.1%), 46 patients had distal (37.1%), and 68 patients had extended disease (54.8%). Patients with proximal disease were significantly more often females (80%) compared with patients with distal (26.1%, p = 0.002) or extended disease (19.1%, p < 0.001) and reported less severe symptoms (VAS 0 vs. VAS 1, p = 0.001). Endoscopic and histological disease was less pronounced in the proximal esophagus of proximal EoE compared to extended disease (EREFS 1.0 vs. 3.0, p = 0.001; 27.0 eos/hpf vs. 52.5 eos/hpf, p = 0.008). Patients with proximal disease were less likely to undergo dilation compared to patients with distal disease in the follow-up (3.3% vs. 23.3%, p = 0.010). In a multivariate Cox regression model, proximal eosinophilia was less likely to be associated with treatment failure compared to distal eosinophilia. Conclusion: Although isolated proximal EoE is infrequent, it is associated with less severe disease and better disease outcome. Proximal disease appears to present a unique EoE phenotype. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Development of a core outcome set for therapeutic studies in eosinophilic esophagitis (COREOS)

Author

Ma, Christopher, Schoepfer, Alain M., Dellon, Evan S., Bredenoord, Albert J., Chehade, Mirna, Collins, Margaret H., Feagan, Brian G., Furuta, Glenn T., Gupta, Sandeep K., Hirano, Ikuo, Jairath, Vipul, Katzka, David A., Pai, Rish K., Rothenberg, Marc E., Straumann, Alex, Aceves, Seema S., Alexander, Jeffrey A., Arva, Nicoleta C., Atkins, Dan, Biedermann, Luc, Blanchard, Carine, Cianferoni, Antonella, Ciriza de los Rios, Constanza, Clayton, Frederic, Davis, Carla M., de Bortoli, Nicola, Dias, Jorge A., Falk, Gary W., Genta, Robert M., Ghaffari, Gisoo, Gonsalves, Nirmala, Greuter, Thomas, Hopp, Russell, Hsu Blatman, Karen S., Jensen, Elizabeth T., Johnston, Doug, Kagalwalla, Amir F., Larsson, Helen M., Leung, John, Louis, Hubert, Masterson, Joanne C., Menard-Katcher, Calies, Menard-Katcher, Paul A., Moawad, Fouad J., Muir, Amanda B., Mukkada, Vincent A., Penagini, Roberto, Pesek, Robert D., Peterson, Kathryn, Putnam, Philip E., Ravelli, Alberto, Savarino, Edoardo V., Schlag, Christoph, Schreiner, Philipp, Simon, Dagmar, Smyrk, Thomas C., Spergel, Jonathan M., Taft, Tiffany H., Terreehorst, Ingrid, Vanuytsel, Tim, Venter, Carina, Vieira, Mario C., Vieth, Michael, Vlieg-Boerstra, Berber, von Arnim, Ulrike, Walker, Marjorie M., Wechsler, Joshua B., Woodland, Philip, Woosley, John T., Yang, Guang-Yu, Zevit, Noam, Safroneeva, Ekaterina, Ma, Christopher, Schoepfer, Alain M., Dellon, Evan S., Bredenoord, Albert J., Chehade, Mirna, Collins, Margaret H., Feagan, Brian G., Furuta, Glenn T., Gupta, Sandeep K., Hirano, Ikuo, Jairath, Vipul, Katzka, David A., Pai, Rish K., Rothenberg, Marc E., Straumann, Alex, Aceves, Seema S., Alexander, Jeffrey A., Arva, Nicoleta C., Atkins, Dan, Biedermann, Luc, Blanchard, Carine, Cianferoni, Antonella, Ciriza de los Rios, Constanza, Clayton, Frederic, Davis, Carla M., de Bortoli, Nicola, Dias, Jorge A., Falk, Gary W., Genta, Robert M., Ghaffari, Gisoo, Gonsalves, Nirmala, Greuter, Thomas, Hopp, Russell, Hsu Blatman, Karen S., Jensen, Elizabeth T., Johnston, Doug, Kagalwalla, Amir F., Larsson, Helen M., Leung, John, Louis, Hubert, Masterson, Joanne C., Menard-Katcher, Calies, Menard-Katcher, Paul A., Moawad, Fouad J., Muir, Amanda B., Mukkada, Vincent A., Penagini, Roberto, Pesek, Robert D., Peterson, Kathryn, Putnam, Philip E., Ravelli, Alberto, Savarino, Edoardo V., Schlag, Christoph, Schreiner, Philipp, Simon, Dagmar, Smyrk, Thomas C., Spergel, Jonathan M., Taft, Tiffany H., Terreehorst, Ingrid, Vanuytsel, Tim, Venter, Carina, Vieira, Mario C., Vieth, Michael, Vlieg-Boerstra, Berber, von Arnim, Ulrike, Walker, Marjorie M., Wechsler, Joshua B., Woodland, Philip, Woosley, John T., Yang, Guang-Yu, Zevit, Noam, and Safroneeva, Ekaterina

Abstract

Background: End points used to determine treatment efficacy in eosinophilic esophagitis (EoE) have evolved over time. With multiple novel therapies in development for EoE, harmonization of outcomes measures will facilitate evidence synthesis and appraisal when comparing different treatments. Objective: We sought to develop a core outcome set (COS) for controlled and observational studies of pharmacologic and diet interventions in adult and pediatric patients with EoE. Methods: Candidate outcomes were generated from systematic literature reviews and patient engagement interviews and surveys. Consensus was established using an iterative Delphi process, with items voted on using a 9-point Likert scale and with feedback from other participants to allow score refinement.

Published
2022

27. Impact of Diagnostic Delay on Disease Course in Pediatric- versus Adult-Onset Patients with Ulcerative Colitis: Data from the Swiss IBD Cohort

Author

Schoepfer, Alain M, Tran, Vu Dang Chau, Rossel, Jean-Benoit, Sokollik, Christiane, Spalinger, Johannes, Safroneeva, Ekaterina, von Graffenried, Thea, Godat, Sébastien, Hahnloser, Dieter, Vavricka, Stephan R, Braegger, Christian, Nydegger, Andreas, Schoepfer, Alain M, Tran, Vu Dang Chau, Rossel, Jean-Benoit, Sokollik, Christiane, Spalinger, Johannes, Safroneeva, Ekaterina, von Graffenried, Thea, Godat, Sébastien, Hahnloser, Dieter, Vavricka, Stephan R, Braegger, Christian, and Nydegger, Andreas

Abstract

INTRODUCTION Given the lack of data, we aimed to assess the impact of the length of diagnostic delay on the natural history of ulcerative colitis (UC) in pediatric (diagnosed <18 years) and adult patients (diagnosed ≥18 years). METHODS Data from the Swiss Inflammatory Bowel Disease Cohort Study were analyzed. Diagnostic delay was defined as the interval between the first appearance of UC-related symptoms until diagnosis. Logistic regression modeling evaluated the appearance of the following complications in the long term according to the length of diagnostic delay: colonic dysplasia, colorectal cancer, UC-related hospitalization, colectomy, and extraintestinal manifestations (EIMs). RESULTS A total of 184 pediatric and 846 adult patients were included. The median diagnostic delay was 4 [IQR 2-7.5] months for the pediatric-onset group and 3 [IQR 2-10] months for the adult-onset group (p = 0.873). In both, pediatric- and adult-onset groups, the length of diagnostic delay at UC diagnosis was not associated with colectomy, UC-related hospitalization, colon dysplasia, and colorectal cancer. EIMs were significantly more prevalent at UC diagnosis in the adult-onset group with long diagnostic delay than in the adult-onset group with short diagnostic delay (p = 0.022). In the long term, the length of diagnostic delay was associated in the adult-onset group with colorectal dysplasia (p = 0.023), EIMs (p < 0.001), and more specifically arthritis/arthralgias (p < 0.001) and ankylosing spondylitis/sacroiliitis (p < 0.001). In the pediatric-onset UC group, the length of diagnostic delay in the long term was associated with arthritis/arthralgias (p = 0.017); however, it was not predictive for colectomy and UC-related hospitalization. CONCLUSIONS As colorectal cancer and EIMs are associated with considerable morbidity and costs, every effort should be made to reduce diagnostic delay in UC patients.

Published
2022

28. Close follow-up is associated with fewer stricture formation and results in earlier detection of histological relapse in the long-term management of eosinophilic esophagitis

Author

Bon, Lorenz, Safroneeva, Ekaterina, Bussmann, Christian, Biedermann, Luc, Schreiner, Philipp; https://orcid.org/0000-0003-1610-1925, Vavricka, Stephan R, Schoepfer, Alain M, McCright-Gill, Talaya, Simon, Hans-Uwe, Straumann, Alex, Chehade, Mirna, Greuter, Thomas; https://orcid.org/0000-0003-2065-3925, Bon, Lorenz, Safroneeva, Ekaterina, Bussmann, Christian, Biedermann, Luc, Schreiner, Philipp; https://orcid.org/0000-0003-1610-1925, Vavricka, Stephan R, Schoepfer, Alain M, McCright-Gill, Talaya, Simon, Hans-Uwe, Straumann, Alex, Chehade, Mirna, and Greuter, Thomas; https://orcid.org/0000-0003-2065-3925

Abstract

BACKGROUND AND AIMS No recommendations exist regarding optimal follow-up schedule in patients with eosinophilic esophagitis (EoE) under maintenance treatment. METHODS We retrospectively evaluated a long-term surveillance concept at the Swiss EoE clinic, where clinical, endoscopic and histological disease activity is assessed annually regardless of EoE symptoms. Data on 159 adult patients under maintenance steroid treatment with available follow-up were analyzed. Patients were classified as having close (duration between visits <18 months) or non-close follow-up (≥18 months). RESULTS We analyzed a total of 309 follow-up visits of 159 patients (123 males, age at diagnosis 38.9 ± 15.4 years). 157 (51%) visits were within a close follow-up schedule (median duration between visits of 1.0 years (interquartile range (IQR) 0.9-1.2)), while 152 visits (49%) were not (median duration between visits 2.9 years (IQR 2.0-4.1)). There was no difference regarding ongoing clinical, endoscopic, and histological disease activity, and adherence to prescribed steroid treatment between the two groups. However, stricture formation was significantly less frequently observed at visits within a close follow-up schedule (22.9 vs. 33.6%, p = 0.038). Absence of close follow-up was a significant risk factor for stricture development in a multivariate regression model. Patients who achieved histological remission and were followed within a close-follow-up schedule had significantly earlier detection of histological relapse compared to patients not within such close follow-up. CONCLUSION Close follow-up is associated with fewer stricture formation and appears to result in earlier detection of histological relapse in patients with eosinophilic esophagitis. We advocate for regular assessment of disease activity (every 12-18 months) in order to detect relapsing disease as early as possible, and therefore potentially minimize the risk for EoE complications.

Published
2022

29. Development of a core outcome set for therapeutic studies in eosinophilic esophagitis (COREOS)

Author

COREOS Collaborators, Ma, Christopher, Schoepfer, Alain M, Dellon, Evan S, Bredenoord, Albert J, Chehade, Mirna, Collins, Margaret H, Feagan, Brian G, Furuta, Glenn T, Gupta, Sandeep K, Hirano, Ikuo, Jairath, Vipul, Katzka, David A, Pai, Rish K, Rothenberg, Marc E, Straumann, Alex, Aceves, Seema S, Alexander, Jeffrey A, Arva, Nicoleta C, Atkins, Dan, Biedermann, Luc, Blanchard, Carine, Cianferoni, Antonella, Ciriza de Los Rios, Constanza, Clayton, Frederic, Davis, Carla M, de Bortoli, Nicola, Dias, Jorge A, Falk, Gary W, Genta, Robert M, et al, COREOS Collaborators, Ma, Christopher, Schoepfer, Alain M, Dellon, Evan S, Bredenoord, Albert J, Chehade, Mirna, Collins, Margaret H, Feagan, Brian G, Furuta, Glenn T, Gupta, Sandeep K, Hirano, Ikuo, Jairath, Vipul, Katzka, David A, Pai, Rish K, Rothenberg, Marc E, Straumann, Alex, Aceves, Seema S, Alexander, Jeffrey A, Arva, Nicoleta C, Atkins, Dan, Biedermann, Luc, Blanchard, Carine, Cianferoni, Antonella, Ciriza de Los Rios, Constanza, Clayton, Frederic, Davis, Carla M, de Bortoli, Nicola, Dias, Jorge A, Falk, Gary W, Genta, Robert M, and et al

Abstract

BACKGROUND End points used to determine treatment efficacy in eosinophilic esophagitis (EoE) have evolved over time. With multiple novel therapies in development for EoE, harmonization of outcomes measures will facilitate evidence synthesis and appraisal when comparing different treatments. OBJECTIVE We sought to develop a core outcome set (COS) for controlled and observational studies of pharmacologic and diet interventions in adult and pediatric patients with EoE. METHODS Candidate outcomes were generated from systematic literature reviews and patient engagement interviews and surveys. Consensus was established using an iterative Delphi process, with items voted on using a 9-point Likert scale and with feedback from other participants to allow score refinement. Consensus meetings were held to ratify the outcome domains of importance and the core outcome measures. Stakeholders were recruited internationally and included adult and pediatric gastroenterologists, allergists, dieticians, pathologists, psychologists, researchers, and methodologists. RESULTS The COS consists of 4 outcome domains for controlled and observational studies: histopathology, endoscopy, patient-reported symptoms, and EoE-specific quality of life. A total of 69 stakeholders (response rate 95.8%) prioritized 42 outcomes in a 2-round Delphi process, and the final ratification meeting generated consensus on 33 outcome measures. These included measurement of the peak eosinophil count, Eosinophilic Esophagitis Histology Scoring System, Eosinophilic Esophagitis Endoscopic Reference Score, and patient-reported measures of dysphagia and quality of life. CONCLUSIONS This interdisciplinary collaboration involving global stakeholders has produced a COS that can be applied to adult and pediatric studies of pharmacologic and diet therapies for EoE and will facilitate meaningful treatment comparisons and improve the quality of data synthesis.

Published
2022

31. DIAGNOSTIC DELAY IN PATIENTS WITH EOSINOPHILIC ESOPHAGITIS HAS NOT CHANGED SINCE FIRST DESCRIPTION 30 YEARS AGO

Author

Murray, Fritz R, Kreienbuehl, Andrea S, Greuter, Thomas, Nennstiel, Simon, Safroneeva, Ekaterina, Saner, Catherine, Schindler, Valeria, Schlag, Christoph, Schoepfer, Alain M, Schreiner, Philipp, Straumann, Alex, and Biedermann, Luc

Subjects
360 Social problems & social services, 610 Medicine & health
Abstract

BACKGROUND AND AIMS Eosinophilic esophagitis (EoE) is a chronic-progressive disease. Diagnostic delay (DD) is associated with increased risk of esophageal strictures and food impactions. We aimed to assess the evolution of DD since EoE's first description in 1993 until 2021. METHODS We analyzed data from patients prospectively included in the Swiss EoE Database. DD was calculated as time-interval between the first occurrence of EoE-symptoms and the confirmed diagnosis. DD was analyzed annually over time (1989-2021) and according to mile stone publications in the field (1993: first description; 2007: first consensus recommendations; and 2011: updated consensus recommendations). In addition, a cox proportional hazards model has been used to describe the relation between diagnostic delay and covariates. RESULTS Complete data of n=1152 patients (male = 857, 74%; median age at diagnosis = 38 years, interquartile range (IQR): 28-49, range, 1-86) were analyzed. Overall, median DD was 4 years (IQR: 1-11, range, 0-56) with DD ≥10 years in 32% of the population. Over time, DD did not significantly change, neither annually, nor according to release dates of mile stone publications with a persistently stable fraction of roughly a third of all patients with a DD of ≥10 years. Both, age at diagnosis (p

Published
2022

35. Diagnostic Delay in Patients With Eosinophilic Esophagitis Has Not Changed Since the First Description 30 Years Ago: Diagnostic Delay in Eosinophilic Esophagitis

Author

Murray, Fritz R, Kreienbuehl, Andrea S, Greuter, Thomas, Nennstiel, Simon, Safroneeva, Ekaterina, Saner, Catherine, Schindler, Valeria, Schlag, Christoph, Schoepfer, Alain M, Schreiner, Philipp, Straumann, Alex, Biedermann, Luc, University of Zurich, and Murray, Fritz R

Subjects
Adult, Male, Aged, 80 and over, Delayed Diagnosis, Adolescent, Hepatology, Gastroenterology, Infant, 610 Medicine & health, Eosinophilic Esophagitis, Middle Aged, Young Adult, 10219 Clinic for Gastroenterology and Hepatology, Child, Preschool, Chronic Disease, Esophageal Stenosis, Humans, Female, 2721 Hepatology, 2715 Gastroenterology, Deglutition Disorders, Child, Aged
Abstract

Eosinophilic esophagitis (EoE) is a chronic progressive disease. Diagnostic delay (DD) is associated with increased risk of esophageal strictures and food impactions. We aimed to assess the evolution of DD since the first description of EoE in 1993 until 2021.We analyzed data from patients prospectively included in the Swiss EoE database. DD was calculated as the time interval between the first occurrence of EoE symptoms and the confirmed diagnosis. DD was analyzed annually over time (1989-2021) and according to milestone publications in the field (1993: first description; 2007: first consensus recommendations; and 2011: updated consensus recommendations). In addition, a Cox proportional hazards model has been used to describe the relation between DD and covariates.Complete data of 1,152 patients (857 male [74%]; median age at diagnosis: 38 years, interquartile range: 28-49, range: 1-86) were analyzed. Overall, median DD was 4 years (interquartile range: 1-11, range, 0-56), with DD ≥ 10 years in 32% of the population. Over time, DD did not significantly change, neither annually nor according to release dates of milestone publications with a persistently stable fraction of roughly one-third of all patients with a DD of ≥10 years. Both ages at diagnosis ( P0.001, with an increase in DD up to the age of 31-40 years) and at symptom onset (younger patients had a longer DD; P0.001) were significantly associated with DD.DD has not changed since the first description of EoE almost 30 years ago and remains substantial. Even today, one-third of patients have a persistently high DD of ≥10 years. Substantial efforts are warranted to increase awareness for EoE and its hallmark symptom, solid food dysphagia, as an age-independent red-flag symptom among healthcare professionals and presumably the general population alike to lower risk of long-term complications.

Published
2022

36. Endoscopic approach to eosinophilic esophagitis: American Society for Gastrointestinal Endoscopy Consensus Conference

Author

Aceves, Seema S., primary, Alexander, Jeffrey A., additional, Baron, Todd H., additional, Bredenoord, Arjan J., additional, Day, Lukejohn, additional, Dellon, Evan S., additional, Falk, Gary W., additional, Furuta, Glenn T., additional, Gonsalves, Nirmala, additional, Hirano, Ikuo, additional, Konda, Vani J.A., additional, Lucendo, Alfredo J., additional, Moawad, Fouad, additional, Peterson, Kathryn A., additional, Putnam, Philip E., additional, Richter, Joel, additional, Schoepfer, Alain M., additional, Straumann, Alex, additional, McBride, Deborah L., additional, Sharma, Prateek, additional, and Katzka, David A., additional

Published
2022
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37. 230. ENDOSCOPIC REFERENCE SCORE REMODELING SUBSCORE AND ESOPHAGEAL EOSINOPHIL COUNT DO NOT CORRELATE IN PLACEBO-TREATED EOSINOPHILIC ESOPHAGITIS PATIENTS FROM DUPILUMAB STUDIES

Author

Hirano, Ikuo, primary, Rothenberg, Marc E, additional, Spergel, Johnathan M, additional, Aceves, Seema, additional, Greenhawt, Matthew, additional, Schoepfer, Alain M, additional, Philpott, Hamish, additional, Chen, Zhen, additional, Radwan, Amr, additional, Khodzhayev, Angela, additional, Deniz, Yamo, additional, Rowe, Paul J, additional, Pela, Tiffany, additional, and Jacob-Nara, Juby A, additional

Published
2022
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38. Diagnostic Delay in Patients With Eosinophilic Esophagitis Has Not Changed Since the First Description 30 Years Ago: Diagnostic Delay in Eosinophilic Esophagitis

Author

Murray, Fritz R., primary, Kreienbuehl, Andrea S., additional, Greuter, Thomas, additional, Nennstiel, Simon, additional, Safroneeva, Ekaterina, additional, Saner, Catherine, additional, Schindler, Valeria, additional, Schlag, Christoph, additional, Schoepfer, Alain M., additional, Schreiner, Philipp, additional, Straumann, Alex, additional, and Biedermann, Luc, additional

Published
2022
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43. A Clinical Severity Index for Eosinophilic Esophagitis: Development, Consensus, and Future Directions

Author

Dellon, Evan S., primary, Khoury, Paneez, additional, Muir, Amanda B., additional, Liacouras, Chris A., additional, Safroneeva, Ekaterina, additional, Atkins, Dan, additional, Collins, Margaret H., additional, Gonsalves, Nirmala, additional, Falk, Gary W., additional, Spergel, Jonathan M., additional, Hirano, Ikuo, additional, Chehade, Mirna, additional, Schoepfer, Alain M., additional, Menard-Katcher, Calies, additional, Katzka, David A., additional, Bonis, Peter A., additional, Bredenoord, Albert J., additional, Geng, Bob, additional, Jensen, Elizabeth T., additional, Pesek, Robert D., additional, Feuerstadt, Paul, additional, Gupta, Sandeep K., additional, Lucendo, Alfredo J., additional, Genta, Robert M., additional, Hiremath, Girish, additional, McGowan, Emily C., additional, Moawad, Fouad J., additional, Peterson, Kathryn A., additional, Rothenberg, Marc E., additional, Straumann, Alex, additional, Furuta, Glenn T., additional, and Aceves, Seema S., additional

Published
2022
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45. Reliability and responsiveness of endoscopic disease activity assessment in eosinophilic esophagitis

Author

Ma, Christopher, primary, Bredenoord, Albert J., additional, Dellon, Evan S., additional, Alexander, Jeffrey A., additional, Biedermann, Luc, additional, Hogan, Malcolm, additional, Guizzetti, Leonardo, additional, Zou, Guangyong, additional, Katzka, David A., additional, Chehade, Mirna, additional, Falk, Gary W., additional, Furuta, Glenn T., additional, Gupta, Sandeep K., additional, Kagalwalla, Amir F., additional, Schoepfer, Alain M., additional, Miehlke, Stephan, additional, Moawad, Fouad J., additional, Peterson, Kathryn, additional, Gonsalves, Nirmala P., additional, Straumann, Alex, additional, Wechsler, Joshua B., additional, Rémillard, Julie, additional, Shackelton, Lisa M., additional, Almonte, Hector S., additional, Feagan, Brian G., additional, Jairath, Vipul, additional, and Hirano, Ikuo, additional

Published
2022
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46. Su1187: DIAGNOSTIC DELAY IN PATIENTS WITH EOSINOPHILIC ESOPHGITIS HAS NOT CHANGED SINCE FIRST DESCRIPTION 30 YEARS AGO

Author

Murray, Fritz R., primary, Kreienbuehl, Andrea, additional, Greuter, Thomas, additional, Nennstiel, Simon, additional, Safroneeva, Ekaterina, additional, Schindler, Valeria, additional, Schlag, Christoph, additional, Schoepfer, Alain M., additional, Schreiner, Philipp, additional, Straumann, Alex, additional, and Biedermann, Luc, additional

Published
2022
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47. Sa1634: PREVALENCE AND IMPACT OF ALCOHOL CONSUMPTION AND CANNABIS USE ON INFLAMMATORY BOWEL DISEASES

Author

Martinho-Grueber, Maude, primary, Kapoglou, Ioannis, additional, Bravo, Francisco, additional, Sarraj, Riad, additional, Benz, Eileen, additional, Restellini, Sophie, additional, Biedermann, Luc, additional, Rogler, Gerhard, additional, Vavricka, Stephan R., additional, Schoepfer, Alain M., additional, Maillard, Michel H., additional, Michetti, Pierre F., additional, Brunner, Felix, additional, Clair, Carole, additional, Barry, Mamadou Pathe, additional, Känel, Roland Von, additional, and Juillerat, Pascal, additional

Published
2022
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48. Sa1182: LONGITUDINAL FOLLOW-UP OF PATIENTS WITH EOSINOPHILIC ESOPHAGITIS VARIANTS AND THEIR POTENTIAL TO PROGRESS TO EOE: A CLINICAL, HISTOLOGICAL AND MOLECULAR MULTI-CENTER ANALYSIS

Author

Greuter, Thomas, primary, Straumann, Alex, additional, Fernandez-Marrero, Yuniel, additional, Germic, Nina, additional, Hosseini, Aref, additional, Yousefi, Shida, additional, Simon, Dagmar, additional, Collins, Margaret H., additional, Bussmann, Christian, additional, Chehade, Mirna, additional, Dellon, Evan S., additional, Furuta, Glenn, additional, Gonsalves, Nirmala, additional, Hirano, Ikuo, additional, Moawad, Fouad J., additional, Biedermann, Luc, additional, Safroneeva, Ekaterina, additional, Schoepfer, Alain M., additional, and Simon, Hans-Uwe, additional

Published
2022
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49. 881: BUDESONIDE ORODISPERSIBLE TABLETS MAINTAIN CLINICAL, HISTOLOGICAL AND ENDOSCOPIC REMISSION IN ADULT PATIENTS WITH EOSINOPHILIC ESOPHAGITIS: RESULTS FROM THE 96-WEEKS OPEN-LABEL EXTENSION PHASE FOLLOWING THE 1-YEAR DOUBLE-BLIND EOS-2 TRIAL

Author

Schlag, Christoph, primary, Straumann, Alex, additional, Lucendo, Alfredo, additional, Miehlke, Stephan, additional, Vieth, Michael, additional, Biedermann, Luc, additional, Santander, Cecilio, additional, Ríos, Constanza Ciriza De Los, additional, Schmöcker, Christoph, additional, Madisch, Ahmed, additional, Hruz, Petr, additional, Hayat, Jamal O., additional, Arnim, Ulrike Von, additional, Bredenoord, Arjan, additional, Schubert, Stefan, additional, Mueller, Ralph, additional, Greinwald, Roland, additional, Schoepfer, Alain M., additional, and Attwood, Stephen E., additional

Published
2022
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50. Systematic Assessment of Adult Patients' Satisfaction with Various Eosinophilic Esophagitis Therapies

Author

Safroneeva, Ekaterina, Hafner, David, Kuehni, Claudia E; https://orcid.org/0000-0001-8957-2002, Zwahlen, Marcel; https://orcid.org/0000-0002-6772-6346, Trelle, Sven, Biedermann, Luc; https://orcid.org/0000-0003-0824-4125, Greuter, Thomas; https://orcid.org/0000-0003-2065-3925, Vavricka, Stephan R, Straumann, Alex, Schoepfer, Alain M; https://orcid.org/0000-0001-6341-9536, Safroneeva, Ekaterina, Hafner, David, Kuehni, Claudia E; https://orcid.org/0000-0001-8957-2002, Zwahlen, Marcel; https://orcid.org/0000-0002-6772-6346, Trelle, Sven, Biedermann, Luc; https://orcid.org/0000-0003-0824-4125, Greuter, Thomas; https://orcid.org/0000-0003-2065-3925, Vavricka, Stephan R, Straumann, Alex, and Schoepfer, Alain M; https://orcid.org/0000-0001-6341-9536

Abstract

BACKGROUND AND AIMS The treatment options for eosinophilic esophagitis (EoE) patients include drugs (proton pump inhibitors [PPIs], swallowed topical corticosteroids [STCs]), elimination diets, and dilation. Given the lack of data, we aimed to assess adult EoE patients' satisfaction with different EoE-specific treatment modalities. PATIENTS AND METHODS We evaluated therapy satisfaction recalled over a 12-month period using the validated Treatment Satisfaction Questionnaire for Medication that assesses effectiveness, side effects, convenience, and overall satisfaction. The score for each scale ranges from 0 (dissatisfied) to 100 (satisfied). To evaluate satisfaction with nonpharmacologic therapies, the questionnaire was modified and debriefed into three focus groups. The final questionnaire was sent to 147 patients. RESULTS The patient response rate was 74%. In the last 12 months, 24, 75, 19, and 9% were treated with PPIs, STCs, elimination diet, and dilation, respectively. Patients identified the following considerations as important for therapy choice: effect on symptoms (89%), effect on esophageal inflammation (76%), side effects (69%), and ease of use (58%). Patients found STCs to be effective (83 points), convenient (83 points), and experienced no side effects when using this therapy. When using STCs alone (43%), overall patient satisfaction was high (86 points). Patients judged PPIs to be most convenient (89 points), STCs to be a bit less convenient (83 points), and diet to be most inconvenient (46 points) of the three therapies examined. CONCLUSIONS Adult EoE patients consider both therapy effect on symptoms and esophageal inflammation as important criteria when choosing EoE therapy and appear to be satisfied with STC use.

Published
2020

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