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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

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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9004232/
https://www.ncbi.nlm.nih.gov/pubmed/35384368
http://dx.doi.org/10.1002/ueg2.12216
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author 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
author_facet 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
author_sort Bon, Lorenz
collection PubMed
description 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.
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spelling pubmed-90042322022-04-15 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 United European Gastroenterol J Neurogastroenterology 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. John Wiley and Sons Inc. 2022-04-05 /pmc/articles/PMC9004232/ /pubmed/35384368 http://dx.doi.org/10.1002/ueg2.12216 Text en © 2022 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Neurogastroenterology
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
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Neurogastroenterology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9004232/
https://www.ncbi.nlm.nih.gov/pubmed/35384368
http://dx.doi.org/10.1002/ueg2.12216
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