Management of suspected and known eosinophilic esophagitis-a nationwide survey in Austria.
Dysphagia
Esophageal Disease
Esophageal Food Impaction
Inflammatory Bowel Disease
Swallowing Disorder
Journal
Wiener klinische Wochenschrift
ISSN: 1613-7671
Titre abrégé: Wien Klin Wochenschr
Pays: Austria
ID NLM: 21620870R
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
28
01
2023
accepted:
19
03
2023
medline:
23
8
2023
pubmed:
19
4
2023
entrez:
18
4
2023
Statut:
ppublish
Résumé
Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus with increasing incidence and dysphagia as the main symptom. The management of suspected or known EoE by Austrian endoscopists has not been investigated yet. A web-based survey with 13 questions about the management of EoE was sent to endoscopists via the Austrian Society of Gastroenterology and Hepatology (ÖGGH). A total of 222 endoscopists (74% gastroenterologists, 23% surgeons, and 2% pediatricians; 68% working in a hospital) from all 9 states participated. In patients with dysphagia but a normal appearing esophagus, 85% of respondents reported always taking biopsies; however, surgeons were less likely to obtain biopsies compared to gastroenterologists ("always" 69% vs. 90%, "sometimes" 29% vs. 10%, "never" 2% vs. 0%, p < 0.001). The approved budesonide orodispersible tablet is the preferred first-line drug used in EoE, ahead of proton pump inhibitors (PPI). Only 65% of participants monitor the patients by endoscopy and histology after 12 weeks of induction therapy, 26% do not continue maintenance therapy, and 22% monitor patients only when symptomatic. The vast majority of Austrian endoscopists adhere to the European and US guidelines in cases of suspected EoE. In contrast, despite the chronic disease course, a significant percentage of providers indicate not to use maintenance therapy and monitor the patients routinely.
Identifiants
pubmed: 37071203
doi: 10.1007/s00508-023-02198-0
pii: 10.1007/s00508-023-02198-0
pmc: PMC10444684
doi:
Substances chimiques
Proton Pump Inhibitors
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
406-413Informations de copyright
© 2023. The Author(s).
Références
de Rooij WE, Barendsen ME, Warners MJ, van Rhijn BD, Verheij J, Bruggink AH, et al. Emerging incidence trends of eosinophilic esophagitis over 25 years: results of a nationwide register-based pathology cohort. Neurogastroenterol Motil. 2021;33(7):e14072.
doi: 10.1111/nmo.14072
pubmed: 33426755
pmcid: 8365671
Miehlke S, von Arnim U, Schlag C, Frieling T, Madisch A, Loibl R, et al. Clinical management of eosinophilic esophagitis—a nationwide survey among gastroenterologists in Germany. Z Gastroenterol. 2019;57(6):745–52.
doi: 10.1055/a-0885-1963
pubmed: 31170743
Schreiner P, Safroneeva E, Schoepfer A, Greuter T, Biedermann L, Schlag C, et al. Management of eosinophilic esophagitis associated food impaction in Europe and the United States. Dis Esophagus. 2022;35(9):doac3. https://doi.org/10.1093/dote/doac003 .
doi: 10.1093/dote/doac003
pubmed: 35088073
Lucendo AJ, Molina-Infante J, Arias A, von Arnim U, Bredenoord AJ, Bussmann C, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United European Gastroenterol J. 2017;5(3):335–58.
doi: 10.1177/2050640616689525
pubmed: 28507746
pmcid: 5415218
Hirano I, Chan ES, Rank MA, Sharaf RN, Stollman NH, Stukus DR, et al. AGA institute and the joint task force on allergy-immunology practice parameters clinical guidelines for the management of eosinophilic esophagitis. Gastroenterology. 2020;158(6):1776–86.
doi: 10.1053/j.gastro.2020.02.038
pubmed: 32359562
Chang JW, Saini SD, Mellinger JL, Chen JW, Zikmund-Fisher BJ, Rubenstein JH. Management of eosinophilic esophagitis is often discordant with guidelines and not patient-centered: results of a survey of gastroenterologists. Dis Esophagus. 2019;32(6):doy133. https://doi.org/10.1093/dote/doy133 .
doi: 10.1093/dote/doy133
pubmed: 30715230
pmcid: 6561423
Zifman E, Banai H, Shamir R, Ringel-Kulka T, Zevit N. Practice differences in the diagnosis and management of eosinophilic esophagitis among adult and pediatric gastroenterologists in Israel. J Pediatr Gastroenterol Nutr. 2018;67(1):34–9.
doi: 10.1097/MPG.0000000000001909
pubmed: 29394215
Murray FR, Kreienbuehl AS, Greuter T, Nennstiel S, Safroneeva E, Saner C, et al. Diagnostic delay in patients with eosinophilic esophagitis has not changed since the first description 30 years ago: diagnostic delay in eosinophilic esophagitis. Am J Gastroenterol. 2022;117(11):1772–9.
doi: 10.14309/ajg.0000000000001950
pubmed: 35971224
Dhar A, Haboubi HN, Attwood SE, Auth MKH, Dunn JM, Sweis R, et al. British society of gastroenterology (BSG) and British society of paediatric gastroenterology, hepatology and nutrition (BSPGHAN) joint consensus guidelines on the diagnosis and management of eosinophilic oesophagitis in children and adults. Gut. 2022;71(8):1459–87.
pubmed: 35606089
Chang JW, Olson S, Kim JY, Dolan R, Greenson J, Sanders G, et al. Loss to follow-up after food impaction among patients with and without eosinophilic esophagitis. Dis Esophagus. 2019;32(12):doz56. https://doi.org/10.1093/dote/doz056 .
doi: 10.1093/dote/doz056
pubmed: 31175359
pmcid: 9115375
Murray FR, Kreienbuhl A, Straumann A, Biedermann L, Schreiner P. Natural history of patients lost to follow-up after esophageal food impaction. Clin Gastroenterol Hepatol. 2022; https://doi.org/10.1016/j.cgh.2022.07.007 .
doi: 10.1016/j.cgh.2022.07.007
pubmed: 35868442
Hillman L, Donohue S, Broman AT, Hoversten P, Gaumnitz E, Lomeli L. Empiric proton pump inhibitor therapy after esophageal food impaction may mask eosinophilic esophagitis diagnosis at follow-up. Dis Esophagus. 2021;34(11):doab30. https://doi.org/10.1093/dote/doab030 .
doi: 10.1093/dote/doab030
pubmed: 33987650
Laserna-Mendieta EJ, Casabona S, Savarino E, Perello A, Perez-Martinez I, Guagnozzi D, et al. Efficacy of therapy for eosinophilic esophagitis in real-world practice. Clin Gastroenterol Hepatol. 2020;18(13):2903–11.e4.
doi: 10.1016/j.cgh.2020.01.024
pubmed: 31988045
Lucendo AJ, Miehlke S, Schlag C, Vieth M, von Arnim U, Molina-Infante J, et al. Efficacy of budesonide orodispersible tablets as induction therapy for eosinophilic esophagitis in a randomized placebo-controlled trial. Gastroenterology. 2019;157(1):74–86.e15.
doi: 10.1053/j.gastro.2019.03.025
pubmed: 30922997
Straumann A, Lucendo AJ, Miehlke S, Vieth M, Schlag C, Biedermann L, et al. Budesonide orodispersible tablets maintain remission in a randomized, placebo-controlled trial of patients with eosinophilic esophagitis. Gastroenterology. 2020;159(5):1672–85.e5.
doi: 10.1053/j.gastro.2020.07.039
pubmed: 32721437
Safroneeva E, Straumann A, Coslovsky M, Zwahlen M, Kuehni CE, Panczak R, et al. Symptoms have modest accuracy in detecting endoscopic and histologic remission in adults with eosinophilic esophagitis. Gastroenterology. 2016;150(3):581–90.e4.
doi: 10.1053/j.gastro.2015.11.004
pubmed: 26584601
Greuter T, Bussmann C, Safroneeva E, Schoepfer AM, Biedermann L, Vavricka SR, et al. Long-term treatment of eosinophilic esophagitis with swallowed topical corticosteroids: development and evaluation of a therapeutic concept. Am J Gastroenterol. 2017;112(10):1527–35.
doi: 10.1038/ajg.2017.202
pubmed: 28719593
Biederman L. Budesonide orodispersible tablets are able to maintain clinical, histological and endoscopic remission in adult patients with eosinophilic esophagitis: results from the 96-weeks open-label extension phase following the 1‑year double-blind EOS‑2 trial. 2022.
Greuter T, Godat A, Ringel A, Almonte HS, Schupack D, Mendoza G, et al. Effectiveness and safety of high—vs low-dose swallowed topical steroids for maintenance treatment of eosinophilic esophagitis: a multicenter observational study. Clin Gastroenterol Hepatol. 2021;19(12):2514–23.e2.
doi: 10.1016/j.cgh.2020.08.027
pubmed: 32798703
Bon L, Safroneeva E, Bussmann C, Biedermann L, Schreiner P, Vavricka SR, et al. 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 Gastroenterol J. 2022;10(3):308–18.
doi: 10.1002/ueg2.12216
pubmed: 35384368
pmcid: 9004232
Chang NC, Thakkar KP, Ketchem CJ, Eluri S, Reed CC, Dellon ES. A gap in care leads to progression of fibrosis in eosinophilic esophagitis patients. Clin Gastroenterol Hepatol. 2022;20(8):1701–8.e2.
doi: 10.1016/j.cgh.2021.10.028
pubmed: 34718172
Leiman DA, Kamal AN, Otaki F, Bredenoord AJ, Dellon ES, Falk GW, et al. Quality indicators for the diagnosis and management of eosinophilic esophagitis. Am J Gastroenterol. 2023; https://doi.org/10.14309/ajg.0000000000002138 .
doi: 10.14309/ajg.0000000000002138
pubmed: 37410934