TY - JOUR
T1 - Proton pump inhibitors in eosinophilic esophagitis (EoE) related to oral immunotherapy
T2 - is it as effective as in other EoE?
AU - Shalem, Tzippora
AU - Cohen, Daniel L.
AU - Epstein-Rigbi, Na’ama
AU - Elizur, Arnon
AU - Eindor-Abarbanel, Adi
AU - Broide, Efrat
AU - Richter, Vered
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2023/12
Y1 - 2023/12
N2 - Oral immunotherapy (OIT) may induce eosinophilic esophagitis (EoE). Proton pump inhibitors (PPIs) are an effective treatment for EoE. However, the effect of PPI treatment is not well established in patients with EoE induced by OIT. Our primary aim was to compare the clinical, endoscopic, and histological response rates to PPIs in children with EoE induced by OIT (EoE+OIT) versus EoE patients without OIT (EoE-OIT). The secondary aims are to describe the clinical and histological features of EoE+OIT. Demographic, clinical, endoscopic, and histological findings of patients with EoE in the gastroenterology clinic at Shamir Medical Center between March 2015 and December 2022 were collected. Comparisons were performed between EoE+OIT and EoE-OIT patients. The study included 42 children (74% male, mean age 11.2), of whom 31 had EoE-OIT and 11 had EoE+OIT. There were no significant differences between groups regarding sex, comorbidities, symptoms, or endoscopic and histological characteristics at diagnosis. All 42 children were treated with PPIs after diagnosis with or without diet changes. The rates of any clinical response were 83.9% and 90.1% in the EoE-OIT group and EoE+OIT group, respectively (p = 1.0). The rate of any endoscopic response was 74.2% for EoE-OIT and 81.8% for EoE+OIT (p = 0.54). Histologically, PPIs were even more effective in the EoE+OIT group, where only 18.2% had no histological response at all compared to 51.6% in the EoE-OIT group (p = 0.1). Conclusion: PPI treatment is as effective in EoE with OIT as it is in EoE due to other etiologies. What is Known: • Proton pump inhibitor (PPI) treatment is effective for achieving clinical response and histologic remission in some patients with eosinophilic esophagitis (EoE). • EoE has also been reported to be triggered by oral immunotherapy (OIT). What is New: • PPI treatment in EoE with OIT is as effective as treatment for EoE due to other etiologies.
AB - Oral immunotherapy (OIT) may induce eosinophilic esophagitis (EoE). Proton pump inhibitors (PPIs) are an effective treatment for EoE. However, the effect of PPI treatment is not well established in patients with EoE induced by OIT. Our primary aim was to compare the clinical, endoscopic, and histological response rates to PPIs in children with EoE induced by OIT (EoE+OIT) versus EoE patients without OIT (EoE-OIT). The secondary aims are to describe the clinical and histological features of EoE+OIT. Demographic, clinical, endoscopic, and histological findings of patients with EoE in the gastroenterology clinic at Shamir Medical Center between March 2015 and December 2022 were collected. Comparisons were performed between EoE+OIT and EoE-OIT patients. The study included 42 children (74% male, mean age 11.2), of whom 31 had EoE-OIT and 11 had EoE+OIT. There were no significant differences between groups regarding sex, comorbidities, symptoms, or endoscopic and histological characteristics at diagnosis. All 42 children were treated with PPIs after diagnosis with or without diet changes. The rates of any clinical response were 83.9% and 90.1% in the EoE-OIT group and EoE+OIT group, respectively (p = 1.0). The rate of any endoscopic response was 74.2% for EoE-OIT and 81.8% for EoE+OIT (p = 0.54). Histologically, PPIs were even more effective in the EoE+OIT group, where only 18.2% had no histological response at all compared to 51.6% in the EoE-OIT group (p = 0.1). Conclusion: PPI treatment is as effective in EoE with OIT as it is in EoE due to other etiologies. What is Known: • Proton pump inhibitor (PPI) treatment is effective for achieving clinical response and histologic remission in some patients with eosinophilic esophagitis (EoE). • EoE has also been reported to be triggered by oral immunotherapy (OIT). What is New: • PPI treatment in EoE with OIT is as effective as treatment for EoE due to other etiologies.
KW - Eosinophilic esophagitis (EoE)
KW - Oral immunotherapy (OIT)
KW - Proton pump inhibitor (PPI)
KW - Treatment efficacy
UR - http://www.scopus.com/inward/record.url?scp=85172708893&partnerID=8YFLogxK
U2 - 10.1007/s00431-023-05228-1
DO - 10.1007/s00431-023-05228-1
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C2 - 37750913
AN - SCOPUS:85172708893
SN - 0340-6199
VL - 182
SP - 5409
EP - 5416
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
IS - 12
ER -