Resident Physician University of Maryland School of Medicine University of Maryland School of Medicine Baltimore, Maryland, United States
Background: Eosinophilic esophagitis (EoE) is an immune mediated disease which occurs in pediatric patients with increasing incidence over the past few decades. While both dietary and pharmacologic therapy are known to be effective in managing the eosinophilic inflammation and clinical symptoms associated with EoE, no definitive treatment regimen has been established.
Objective: The objectives were to determine the modes of treatment, rates of obtaining histologic remission, and self-reported treatment adherence rates of patients at our institution. We additionally attempted to identify predictors of remission and adherence.
Design/Methods: We collected data retrospectively and prospectively, and performed a retrospective review of patients diagnosed with EoE between 2013 and 2020. Bivariate analyses were performed comparing subjects who obtained remission versus those who did not obtain remission, and comparing those who were adherent to treatment regimen versus those who were not adherent. Continuous, categorical, and binary variables were analyzed using T-test, Chi-Square, and Fisher Exact testing as appropriate.
Results: 19 pediatric patients diagnosed with EoE were included in our cohort. The most common form of treatment was dietary therapy alone (10/19, 53%). 14 of 19 (74%) patients obtained histologic remission at some point in treatment. 10 of 19 (53%) patients included were not consistently adherent to their treatment regimen. There were comparable adherence rates in those on dietary therapy (56%) and steroid therapy (44%). Demographic factors, including race, sex, and age did not predict remission or adherence. Conclusion(s): Even though no definitive and uniform treatment regimen for EoE has been established, it is encouraging that the majority of patients in the cohort demonstrated histologic remission at some point. However, the similar rates of nonadherence reported for dietary and steroid therapy indicate that barriers exist to both forms of management.
This chart demonstrates the breakdown of treatment methods for the 19 patients in our cohort.
This graph shows the percentage of patients in our cohort who experienced remission at any time and the percentage of patients who had histologic remission on their most recent scope.
This table shows self reported adherence rates for patients in the cohort based on chart review.
Authors/Institutions: Minna L. Leydorf, University of Maryland School of Medicine, Baltimore, Maryland, United States; Anupama Kewalramani, University of Maryland School of Medicine, Baltimore, Maryland, United States; Natalie L. Davis, University of Maryland School of Medicine, Baltimore, Maryland, United States