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.

Bon, Lorenz; Safroneeva, Ekaterina; Bussmann, Christian; Biedermann, Luc; Schreiner, Philipp; Vavricka, Stephan R; Schoepfer, Alain M; McCright-Gill, Talaya; Simon, Hans-Uwe; Straumann, Alex; Chehade, Mirna; Greuter, Thomas (2022). 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. United European gastroenterology journal, 10(3), pp. 308-318. Wiley 10.1002/ueg2.12216

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Pharmacology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Safroneeva, Ekaterina and Simon, Hans-Uwe

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2050-6414

Publisher:

Wiley

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Pubmed Import

Date Deposited:

07 Apr 2022 10:57

Last Modified:

21 Apr 2022 11:40

Publisher DOI:

10.1002/ueg2.12216

PubMed ID:

35384368

Uncontrolled Keywords:

eosinophilic esophagitis esophagus long-term outcome relapse swallowed topical corticosteroids

BORIS DOI:

10.48350/169091

URI:

https://boris.unibe.ch/id/eprint/169091

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