Sex impacts disease activity but not symptoms or quality of life in adults with eosinophilic esophagitis.

Schreiner, Philipp; Safroneeva, Ekaterina; Rossel, Jean-Benoit; Limacher, Andreas; Saner, Catherine; Greuter, Thomas; Schoepfer, Alain; Straumann, Alex; Biedermann, Luc (2022). Sex impacts disease activity but not symptoms or quality of life in adults with eosinophilic esophagitis. Clinical gastroenterology and hepatology, 20(8), 1729-1738.e1. Elsevier 10.1016/j.cgh.2021.11.009

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BACKGROUND

Eosinophilic esophagitis (EoE) has a strong male predominance that appears at least partially due to genetic susceptibility. However, data regarding sex-related differences in patients with EoE are scarce.

METHODS

We analyzed prospectively collected data from adults enrolled into the Swiss EoE cohort study (SEECS). Patients with and without dilation in the past 12 months completed patient-reported EoE activity index (EEsAI) and EoE-specific QoL (EoE-QoL-A) and underwent endoscopy with biopsies. We used linear regression with EEsAI or EoE-QoL-A as the outcome, eosinophils per high power field, rings and strictures, current therapy use, and disease duration as predictors.

RESULTS

A total of 266 patients (77% male, median age at diagnosis 35.8 years, median disease duration 10.4 years) were seen during 408 visits. Men had a longer diagnostic delay (62 vs. 36 months, p = 0.022), had higher endoscopic disease activity (EREFS median 3.0, IQR 1.0-6.0 vs. EREFS median 2.0, IQR 0.0-4.0, p = 0.010), more microabscesses (25% vs. 13%, p = 0.025) and more often fibrosis of the lamina propria (mild/moderate 74.7% vs. 61.5%, severe 9.1% vs. 5.8%, p = 0.047) than women. When adjusting for objective measures of disease activity, disease duration and current therapy use, we did not observe differences in EEsAI or EoE-QoL-A between women and men.

CONCLUSIONS

Male EoE patients had higher endoscopic and histologic disease activity than female patients. When adjusting for biologic activity and therapy use we did not identify differences in symptom severity or EoE-specific QoL between male and female EoE patient.

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