Upper GI Tract

Key clinical point: People from a tertiary care center database were at a significantly increased risk of getting eosinophilic esophagitis (EoE) when they lived close (<1 mile) to a commercial swine farm or in an area with a high density of swine farm operations.

Major finding: Odds of EoE were ~2.5 times higher in participants who had undergone upper endoscopy and lived in an area with <1 mile proximity to a permitted swine facility (adjusted odds ratio [aOR] 2.56; 95% CI 1.33-4.95) or where the density of swine farms was >10 farms per census tract (aOR 2.76; 95% CI 1.30-5.84).

Study details: This case-control study including 401 patients with EoE and 1852 control individuals who had undergone endoscopy but did not show any esophageal pathology from a tertiary care center and 904 patients with EoE and 4074 endoscopy-based control participants from a pathology database.

Disclosures: This study was partly funded by a grant from the US National Institutes of Health. The authors declared no conflicts of interest.

Source: Cotton CC et al. Proximity to swine farming operations as a risk factor for eosinophilic esophagitis. JPGN Rep. 2023;4(4):e391 (Nov 8). doi: 10.1097/PG9.0000000000000391

Key clinical point: People from a tertiary care center database were at a significantly increased risk of getting eosinophilic esophagitis (EoE) when they lived close (<1 mile) to a commercial swine farm or in an area with a high density of swine farm operations.

Major finding: Odds of EoE were ~2.5 times higher in participants who had undergone upper endoscopy and lived in an area with <1 mile proximity to a permitted swine facility (adjusted odds ratio [aOR] 2.56; 95% CI 1.33-4.95) or where the density of swine farms was >10 farms per census tract (aOR 2.76; 95% CI 1.30-5.84).

Study details: This case-control study including 401 patients with EoE and 1852 control individuals who had undergone endoscopy but did not show any esophageal pathology from a tertiary care center and 904 patients with EoE and 4074 endoscopy-based control participants from a pathology database.

Disclosures: This study was partly funded by a grant from the US National Institutes of Health. The authors declared no conflicts of interest.

Source: Cotton CC et al. Proximity to swine farming operations as a risk factor for eosinophilic esophagitis. JPGN Rep. 2023;4(4):e391 (Nov 8). doi: 10.1097/PG9.0000000000000391

Key clinical point: People from a tertiary care center database were at a significantly increased risk of getting eosinophilic esophagitis (EoE) when they lived close (<1 mile) to a commercial swine farm or in an area with a high density of swine farm operations.

Major finding: Odds of EoE were ~2.5 times higher in participants who had undergone upper endoscopy and lived in an area with <1 mile proximity to a permitted swine facility (adjusted odds ratio [aOR] 2.56; 95% CI 1.33-4.95) or where the density of swine farms was >10 farms per census tract (aOR 2.76; 95% CI 1.30-5.84).

Study details: This case-control study including 401 patients with EoE and 1852 control individuals who had undergone endoscopy but did not show any esophageal pathology from a tertiary care center and 904 patients with EoE and 4074 endoscopy-based control participants from a pathology database.

Disclosures: This study was partly funded by a grant from the US National Institutes of Health. The authors declared no conflicts of interest.

Source: Cotton CC et al. Proximity to swine farming operations as a risk factor for eosinophilic esophagitis. JPGN Rep. 2023;4(4):e391 (Nov 8). doi: 10.1097/PG9.0000000000000391

Key clinical point: The eosinophilic esophagitis (EoE) histology scoring system (HSS) can predict the response to proton pump inhibitor (PPI) therapy in pediatric patients with EoE.

Major finding: The final EoEHSS grade score for the middle segment of the esophagus was significantly lower in patients who responded (peak eosinophil count < 15/high-power field on esophageal biopsy) vs did not respond to PPI therapy (0.3 vs 0.5; P = .037). Responders vs nonresponders had significantly lower grade values for the individual EoEHSS parameters eosinophilic abscesses (P = .044) and eosinophil surface layering (P = .046) for the middle esophagus.

Study details: Findings are from a cross-sectional study including 89 pediatric patients with EoE (age 0-18 years) who received PPI daily and were either responsive (n = 17) or nonresponsive (n = 72) at 3 months of therapy.

Disclosures: This study did not receive any external funding. The authors declared no conflicts of interest.

Source: Jevtić J et al. The usefulness of the eosinophilic esophagitis histology scoring system in predicting response to proton pump inhibitor monotherapy in children with eosinophilic esophagitis. Diagnostics (Basel). 2023; 13(22):3445 (Nov 15). doi: 10.3390/diagnostics13223445

Key clinical point: The eosinophilic esophagitis (EoE) histology scoring system (HSS) can predict the response to proton pump inhibitor (PPI) therapy in pediatric patients with EoE.

Major finding: The final EoEHSS grade score for the middle segment of the esophagus was significantly lower in patients who responded (peak eosinophil count < 15/high-power field on esophageal biopsy) vs did not respond to PPI therapy (0.3 vs 0.5; P = .037). Responders vs nonresponders had significantly lower grade values for the individual EoEHSS parameters eosinophilic abscesses (P = .044) and eosinophil surface layering (P = .046) for the middle esophagus.

Study details: Findings are from a cross-sectional study including 89 pediatric patients with EoE (age 0-18 years) who received PPI daily and were either responsive (n = 17) or nonresponsive (n = 72) at 3 months of therapy.

Disclosures: This study did not receive any external funding. The authors declared no conflicts of interest.

Source: Jevtić J et al. The usefulness of the eosinophilic esophagitis histology scoring system in predicting response to proton pump inhibitor monotherapy in children with eosinophilic esophagitis. Diagnostics (Basel). 2023; 13(22):3445 (Nov 15). doi: 10.3390/diagnostics13223445

Key clinical point: The eosinophilic esophagitis (EoE) histology scoring system (HSS) can predict the response to proton pump inhibitor (PPI) therapy in pediatric patients with EoE.

Major finding: The final EoEHSS grade score for the middle segment of the esophagus was significantly lower in patients who responded (peak eosinophil count < 15/high-power field on esophageal biopsy) vs did not respond to PPI therapy (0.3 vs 0.5; P = .037). Responders vs nonresponders had significantly lower grade values for the individual EoEHSS parameters eosinophilic abscesses (P = .044) and eosinophil surface layering (P = .046) for the middle esophagus.

Study details: Findings are from a cross-sectional study including 89 pediatric patients with EoE (age 0-18 years) who received PPI daily and were either responsive (n = 17) or nonresponsive (n = 72) at 3 months of therapy.

Disclosures: This study did not receive any external funding. The authors declared no conflicts of interest.

Source: Jevtić J et al. The usefulness of the eosinophilic esophagitis histology scoring system in predicting response to proton pump inhibitor monotherapy in children with eosinophilic esophagitis. Diagnostics (Basel). 2023; 13(22):3445 (Nov 15). doi: 10.3390/diagnostics13223445

Key clinical point: Elderly patients with eosinophilic esophagitis (EoE) symptoms had <50% the odds of undergoing esophageal biopsies and longer time to diagnosis after the onset of symptoms compared with non-elderly patients.

Major finding: Elderly vs non-elderly patients were 56% less likely to undergo esophageal biopsies (adjusted odds ratio [aOR] 0.44; 95% CI 0.21-0.92) and had significantly longer time to diagnosis following symptom onset (aOR per year of symptoms preceding diagnosis 1.08; 95% CI 1.04-1.11).

Study details: The data come from a retrospective cohort study including elderly (age ≥ 65 years; n = 91) or non-elderly (age < 65 years; n = 102) patients with newly diagnosed EoE who presented with symptoms including dysphagia, chest pain, and heartburn.

Disclosures: This study was supported by a grant presented by the University of North Carolina Medical Student Summer Research Program. ES Dellon declared serving as a consultant for and receiving research funding and educational grants from various sources. The other authors declared no conflicts of interest.

Source: Kiran A et al. Retrospective cohort study: Effect of age as a barrier to diagnosis of eosinophilic oesophagitis. Aliment Pharmacol Ther. 2023 (Oct 25). doi: 10.1111/apt.17781

Key clinical point: Elderly patients with eosinophilic esophagitis (EoE) symptoms had <50% the odds of undergoing esophageal biopsies and longer time to diagnosis after the onset of symptoms compared with non-elderly patients.

Major finding: Elderly vs non-elderly patients were 56% less likely to undergo esophageal biopsies (adjusted odds ratio [aOR] 0.44; 95% CI 0.21-0.92) and had significantly longer time to diagnosis following symptom onset (aOR per year of symptoms preceding diagnosis 1.08; 95% CI 1.04-1.11).

Study details: The data come from a retrospective cohort study including elderly (age ≥ 65 years; n = 91) or non-elderly (age < 65 years; n = 102) patients with newly diagnosed EoE who presented with symptoms including dysphagia, chest pain, and heartburn.

Disclosures: This study was supported by a grant presented by the University of North Carolina Medical Student Summer Research Program. ES Dellon declared serving as a consultant for and receiving research funding and educational grants from various sources. The other authors declared no conflicts of interest.

Source: Kiran A et al. Retrospective cohort study: Effect of age as a barrier to diagnosis of eosinophilic oesophagitis. Aliment Pharmacol Ther. 2023 (Oct 25). doi: 10.1111/apt.17781

Key clinical point: Elderly patients with eosinophilic esophagitis (EoE) symptoms had <50% the odds of undergoing esophageal biopsies and longer time to diagnosis after the onset of symptoms compared with non-elderly patients.

Major finding: Elderly vs non-elderly patients were 56% less likely to undergo esophageal biopsies (adjusted odds ratio [aOR] 0.44; 95% CI 0.21-0.92) and had significantly longer time to diagnosis following symptom onset (aOR per year of symptoms preceding diagnosis 1.08; 95% CI 1.04-1.11).

Study details: The data come from a retrospective cohort study including elderly (age ≥ 65 years; n = 91) or non-elderly (age < 65 years; n = 102) patients with newly diagnosed EoE who presented with symptoms including dysphagia, chest pain, and heartburn.

Disclosures: This study was supported by a grant presented by the University of North Carolina Medical Student Summer Research Program. ES Dellon declared serving as a consultant for and receiving research funding and educational grants from various sources. The other authors declared no conflicts of interest.

Source: Kiran A et al. Retrospective cohort study: Effect of age as a barrier to diagnosis of eosinophilic oesophagitis. Aliment Pharmacol Ther. 2023 (Oct 25). doi: 10.1111/apt.17781

Key clinical point: The phenotypes of eosinophilic esophagitis (EoE) have evolved over the past two decades, with an increase in both age at diagnosis and age at onset of symptoms.

Major finding: The interval 2017-2021 vs 2002-2006 was associated with a significant increase in age at diagnosis (31.8 vs 22.0 years), frequency of dysphagia (92% vs 67%), proportion of patients with mixed presentation of inflammatory and fibrostenotic findings (68% vs 26%), and proportion of patients (age groups ≥18 years and ≥12 years) having later EoE symptom onset (all P < .001). The increase in the mixed phenotype rate persisted for the intervals after multivariate adjustment (adjusted odds ratio 1.51/interval; 95% CI 1.31-1.73).

Study details: This retrospective cohort study included 1187 adults or children (age < 18 years) with newly diagnosed EoE.

Disclosures: This study was supported by grants from the US National Institutes of Health. The authors declared no conflicts of interest.

Source: Kiran A et al. Increasing age at the time of diagnosis and evolving phenotypes of eosinophilic esophagitis over 20 years. Dig Dis Sci. 2023 (Nov 15). doi: 10.1007/s10620-023-08165-z

Key clinical point: The phenotypes of eosinophilic esophagitis (EoE) have evolved over the past two decades, with an increase in both age at diagnosis and age at onset of symptoms.

Major finding: The interval 2017-2021 vs 2002-2006 was associated with a significant increase in age at diagnosis (31.8 vs 22.0 years), frequency of dysphagia (92% vs 67%), proportion of patients with mixed presentation of inflammatory and fibrostenotic findings (68% vs 26%), and proportion of patients (age groups ≥18 years and ≥12 years) having later EoE symptom onset (all P < .001). The increase in the mixed phenotype rate persisted for the intervals after multivariate adjustment (adjusted odds ratio 1.51/interval; 95% CI 1.31-1.73).

Study details: This retrospective cohort study included 1187 adults or children (age < 18 years) with newly diagnosed EoE.

Disclosures: This study was supported by grants from the US National Institutes of Health. The authors declared no conflicts of interest.

Source: Kiran A et al. Increasing age at the time of diagnosis and evolving phenotypes of eosinophilic esophagitis over 20 years. Dig Dis Sci. 2023 (Nov 15). doi: 10.1007/s10620-023-08165-z

Key clinical point: The phenotypes of eosinophilic esophagitis (EoE) have evolved over the past two decades, with an increase in both age at diagnosis and age at onset of symptoms.

Major finding: The interval 2017-2021 vs 2002-2006 was associated with a significant increase in age at diagnosis (31.8 vs 22.0 years), frequency of dysphagia (92% vs 67%), proportion of patients with mixed presentation of inflammatory and fibrostenotic findings (68% vs 26%), and proportion of patients (age groups ≥18 years and ≥12 years) having later EoE symptom onset (all P < .001). The increase in the mixed phenotype rate persisted for the intervals after multivariate adjustment (adjusted odds ratio 1.51/interval; 95% CI 1.31-1.73).

Study details: This retrospective cohort study included 1187 adults or children (age < 18 years) with newly diagnosed EoE.

Disclosures: This study was supported by grants from the US National Institutes of Health. The authors declared no conflicts of interest.

Source: Kiran A et al. Increasing age at the time of diagnosis and evolving phenotypes of eosinophilic esophagitis over 20 years. Dig Dis Sci. 2023 (Nov 15). doi: 10.1007/s10620-023-08165-z

Key clinical point: Whole-blood IL5RA expression could serve as a noninvasive biomarker for the diagnosis of eosinophilic esophagitis (EoE).

Major finding: The expression of IL5RA was 2.36-fold higher in patients with EoE vs control individuals (P = .001). The value of area under the concentration-time curve for differentiating between the two groups was 0.85. IL5RA expression levels correlated significantly with the baseline tissue esophageal eosinophil counts on biopsy specimens (Pearson R = 0.62; P < .0001) and were associated with the total baseline endoscopy reference score (Pearson R = 0.52; P < .001).

Study details: This prospective study analyzed the whole blood samples of 20 patients with EoE who were treated with topical corticosteroids for 8 weeks before undergoing endoscopy and 20 control individuals without EoE.

Disclosures: This study was supported by grants from the US National Institutes of Health. The authors declared no conflicts of interest.

Source: Sninsky JA et al. Peripheral blood IL5RA gene expression as a diagnostic biomarker for eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2023 (Nov 7). doi: 10.1016/j.cgh.2023.10.028

Key clinical point: Whole-blood IL5RA expression could serve as a noninvasive biomarker for the diagnosis of eosinophilic esophagitis (EoE).

Major finding: The expression of IL5RA was 2.36-fold higher in patients with EoE vs control individuals (P = .001). The value of area under the concentration-time curve for differentiating between the two groups was 0.85. IL5RA expression levels correlated significantly with the baseline tissue esophageal eosinophil counts on biopsy specimens (Pearson R = 0.62; P < .0001) and were associated with the total baseline endoscopy reference score (Pearson R = 0.52; P < .001).

Study details: This prospective study analyzed the whole blood samples of 20 patients with EoE who were treated with topical corticosteroids for 8 weeks before undergoing endoscopy and 20 control individuals without EoE.

Disclosures: This study was supported by grants from the US National Institutes of Health. The authors declared no conflicts of interest.

Source: Sninsky JA et al. Peripheral blood IL5RA gene expression as a diagnostic biomarker for eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2023 (Nov 7). doi: 10.1016/j.cgh.2023.10.028

Key clinical point: Whole-blood IL5RA expression could serve as a noninvasive biomarker for the diagnosis of eosinophilic esophagitis (EoE).

Major finding: The expression of IL5RA was 2.36-fold higher in patients with EoE vs control individuals (P = .001). The value of area under the concentration-time curve for differentiating between the two groups was 0.85. IL5RA expression levels correlated significantly with the baseline tissue esophageal eosinophil counts on biopsy specimens (Pearson R = 0.62; P < .0001) and were associated with the total baseline endoscopy reference score (Pearson R = 0.52; P < .001).

Study details: This prospective study analyzed the whole blood samples of 20 patients with EoE who were treated with topical corticosteroids for 8 weeks before undergoing endoscopy and 20 control individuals without EoE.

Disclosures: This study was supported by grants from the US National Institutes of Health. The authors declared no conflicts of interest.

Source: Sninsky JA et al. Peripheral blood IL5RA gene expression as a diagnostic biomarker for eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2023 (Nov 7). doi: 10.1016/j.cgh.2023.10.028

Key clinical point: A family history of eczema and a diet lacking allergenic foods, such as milk, increased the risk for incident eosinophilic esophagitis (EoE) in children with aerodigestive dysfunction who underwent triple endoscopy.

Major finding: A family history of eczema increased the odds of a future diagnosis EoE by ~4 times (odds ratio [OR] 4.02; P = .006) whereas a diet containing dairy significantly lowered the risk for incident EoE (OR 0.26, P = .02).

Study details: Findings are from a study including 119 patients with aerodigestive dysfunction who were age 0-21 years and underwent triple endoscopy (flexible bronchoscopy, rigid direct laryngoscopy + bronchoscopy, and esophagoscopy with biopsy), of whom 19 had EoE.

Disclosures: This study was supported by the US National Institutes of Health/National Center for Advancing Translational Science. AM Loizides declared serving as the Medical Director of Clinical Development at Albireo Pharma.

Source: Moran S et al. Factors associated with eosinophilic esophagitis in an urban, tertiary care pediatric aerodigestive population undergoing triple endoscopy. Am J Otolaryngol. 2023;45(1):104096 (Nov 5). doi: 10.1016/j.amjoto.2023.104096

Key clinical point: A family history of eczema and a diet lacking allergenic foods, such as milk, increased the risk for incident eosinophilic esophagitis (EoE) in children with aerodigestive dysfunction who underwent triple endoscopy.

Major finding: A family history of eczema increased the odds of a future diagnosis EoE by ~4 times (odds ratio [OR] 4.02; P = .006) whereas a diet containing dairy significantly lowered the risk for incident EoE (OR 0.26, P = .02).

Study details: Findings are from a study including 119 patients with aerodigestive dysfunction who were age 0-21 years and underwent triple endoscopy (flexible bronchoscopy, rigid direct laryngoscopy + bronchoscopy, and esophagoscopy with biopsy), of whom 19 had EoE.

Disclosures: This study was supported by the US National Institutes of Health/National Center for Advancing Translational Science. AM Loizides declared serving as the Medical Director of Clinical Development at Albireo Pharma.

Source: Moran S et al. Factors associated with eosinophilic esophagitis in an urban, tertiary care pediatric aerodigestive population undergoing triple endoscopy. Am J Otolaryngol. 2023;45(1):104096 (Nov 5). doi: 10.1016/j.amjoto.2023.104096

Key clinical point: A family history of eczema and a diet lacking allergenic foods, such as milk, increased the risk for incident eosinophilic esophagitis (EoE) in children with aerodigestive dysfunction who underwent triple endoscopy.

Major finding: A family history of eczema increased the odds of a future diagnosis EoE by ~4 times (odds ratio [OR] 4.02; P = .006) whereas a diet containing dairy significantly lowered the risk for incident EoE (OR 0.26, P = .02).

Study details: Findings are from a study including 119 patients with aerodigestive dysfunction who were age 0-21 years and underwent triple endoscopy (flexible bronchoscopy, rigid direct laryngoscopy + bronchoscopy, and esophagoscopy with biopsy), of whom 19 had EoE.

Disclosures: This study was supported by the US National Institutes of Health/National Center for Advancing Translational Science. AM Loizides declared serving as the Medical Director of Clinical Development at Albireo Pharma.

Source: Moran S et al. Factors associated with eosinophilic esophagitis in an urban, tertiary care pediatric aerodigestive population undergoing triple endoscopy. Am J Otolaryngol. 2023;45(1):104096 (Nov 5). doi: 10.1016/j.amjoto.2023.104096

Key clinical point: The risk for inflammatory bowel diseases (IBD), particularly Crohn’s disease, was 3.5 times higher in patients with eosinophilic esophagitis (EoE).

Major finding: Compared with control individuals without EoE, patients with EoE were at a ~3.5-fold increased risk for IBD (adjusted hazard ratio [aHR] 3.56; 95% CI 1.79-7.11), particularly Crohn’s disease (aHR 3.39; 95% CI 1.2-9.60). When compared with siblings of patients with EoE, 12 patients with EoE were diagnosed with IBD later in life compared with 11 siblings, which corresponded to an aHR of 2.48 (95% CI 0.92-6.70).

Study details: Findings are from a nationwide cohort study including 1587 patients with histologically verified EoE and 7808 age- and sex-matched control individuals without EoE.

Disclosures: This study was funded by the Consortium of Eosinophilic Gastrointestinal Disease Researcher Training Program and Karolinska Institutet, Sweden. Some authors declared serving as consultants, advisors, or speakers for or receiving financial support, grants, or fees for lectures from Karolinska Institutet and other sources.

Source: Uchida AM et al. Eosinophilic esophagitis is associated with increased risk of later inflammatory bowel disease in a nationwide Swedish population cohort. United European Gastroenterol J. 2023 (Dec 7). doi: 10.1002/ueg2.12493

Key clinical point: The risk for inflammatory bowel diseases (IBD), particularly Crohn’s disease, was 3.5 times higher in patients with eosinophilic esophagitis (EoE).

Major finding: Compared with control individuals without EoE, patients with EoE were at a ~3.5-fold increased risk for IBD (adjusted hazard ratio [aHR] 3.56; 95% CI 1.79-7.11), particularly Crohn’s disease (aHR 3.39; 95% CI 1.2-9.60). When compared with siblings of patients with EoE, 12 patients with EoE were diagnosed with IBD later in life compared with 11 siblings, which corresponded to an aHR of 2.48 (95% CI 0.92-6.70).

Study details: Findings are from a nationwide cohort study including 1587 patients with histologically verified EoE and 7808 age- and sex-matched control individuals without EoE.

Disclosures: This study was funded by the Consortium of Eosinophilic Gastrointestinal Disease Researcher Training Program and Karolinska Institutet, Sweden. Some authors declared serving as consultants, advisors, or speakers for or receiving financial support, grants, or fees for lectures from Karolinska Institutet and other sources.

Source: Uchida AM et al. Eosinophilic esophagitis is associated with increased risk of later inflammatory bowel disease in a nationwide Swedish population cohort. United European Gastroenterol J. 2023 (Dec 7). doi: 10.1002/ueg2.12493

Key clinical point: The risk for inflammatory bowel diseases (IBD), particularly Crohn’s disease, was 3.5 times higher in patients with eosinophilic esophagitis (EoE).

Major finding: Compared with control individuals without EoE, patients with EoE were at a ~3.5-fold increased risk for IBD (adjusted hazard ratio [aHR] 3.56; 95% CI 1.79-7.11), particularly Crohn’s disease (aHR 3.39; 95% CI 1.2-9.60). When compared with siblings of patients with EoE, 12 patients with EoE were diagnosed with IBD later in life compared with 11 siblings, which corresponded to an aHR of 2.48 (95% CI 0.92-6.70).

Study details: Findings are from a nationwide cohort study including 1587 patients with histologically verified EoE and 7808 age- and sex-matched control individuals without EoE.

Disclosures: This study was funded by the Consortium of Eosinophilic Gastrointestinal Disease Researcher Training Program and Karolinska Institutet, Sweden. Some authors declared serving as consultants, advisors, or speakers for or receiving financial support, grants, or fees for lectures from Karolinska Institutet and other sources.

Source: Uchida AM et al. Eosinophilic esophagitis is associated with increased risk of later inflammatory bowel disease in a nationwide Swedish population cohort. United European Gastroenterol J. 2023 (Dec 7). doi: 10.1002/ueg2.12493

Key clinical point: Budesonide oral suspension (BOS) significantly improved most of the efficacy outcomes in adolescents with eosinophilic esophagitis (EoE) over 12 weeks.

Major finding: At week 12, a significantly higher number of adolescents receiving BOS vs placebo achieved histologic (≤6, ≤1, and <15 eosinophils/high-power field; all P < .001) and clinicopathologic (P = .003) responses. BOS vs placebo led to greater reductions in the EoE histology scoring system grade (P < .001) and total EoE endoscopic reference scores (P = .021). Treatment-emergent adverse events were mild or moderate in severity.

Study details: This post hoc analysis of pooled data from a phase 2 and a phase 3 study included 76 adolescents with EoE (age 11-17 years) who were randomly assigned to receive 2 mg BOS twice daily or placebo.

Disclosures: These studies were funded by Shire ViroPharma, Inc., a Takeda company, and Meritage Pharma, Inc. (now part of Shire). Some authors declared serving as consultants for or receiving research funding, etc., from Meritage, Shire, and others. Four authors declared being employees and stockholders of Takeda.

Source: Mukkada VA et al. Pooled phase 2 and 3 efficacy and safety data on budesonide oral suspension in adolescents with eosinophilic esophagitis. J Pediatr Gastroenterol Nutr. 2023;77(6):760-768 (Sep 18). doi: 10.1097/MPG.0000000000003948

Key clinical point: Budesonide oral suspension (BOS) significantly improved most of the efficacy outcomes in adolescents with eosinophilic esophagitis (EoE) over 12 weeks.

Major finding: At week 12, a significantly higher number of adolescents receiving BOS vs placebo achieved histologic (≤6, ≤1, and <15 eosinophils/high-power field; all P < .001) and clinicopathologic (P = .003) responses. BOS vs placebo led to greater reductions in the EoE histology scoring system grade (P < .001) and total EoE endoscopic reference scores (P = .021). Treatment-emergent adverse events were mild or moderate in severity.

Study details: This post hoc analysis of pooled data from a phase 2 and a phase 3 study included 76 adolescents with EoE (age 11-17 years) who were randomly assigned to receive 2 mg BOS twice daily or placebo.

Disclosures: These studies were funded by Shire ViroPharma, Inc., a Takeda company, and Meritage Pharma, Inc. (now part of Shire). Some authors declared serving as consultants for or receiving research funding, etc., from Meritage, Shire, and others. Four authors declared being employees and stockholders of Takeda.

Source: Mukkada VA et al. Pooled phase 2 and 3 efficacy and safety data on budesonide oral suspension in adolescents with eosinophilic esophagitis. J Pediatr Gastroenterol Nutr. 2023;77(6):760-768 (Sep 18). doi: 10.1097/MPG.0000000000003948

Key clinical point: Budesonide oral suspension (BOS) significantly improved most of the efficacy outcomes in adolescents with eosinophilic esophagitis (EoE) over 12 weeks.

Major finding: At week 12, a significantly higher number of adolescents receiving BOS vs placebo achieved histologic (≤6, ≤1, and <15 eosinophils/high-power field; all P < .001) and clinicopathologic (P = .003) responses. BOS vs placebo led to greater reductions in the EoE histology scoring system grade (P < .001) and total EoE endoscopic reference scores (P = .021). Treatment-emergent adverse events were mild or moderate in severity.

Study details: This post hoc analysis of pooled data from a phase 2 and a phase 3 study included 76 adolescents with EoE (age 11-17 years) who were randomly assigned to receive 2 mg BOS twice daily or placebo.

Disclosures: These studies were funded by Shire ViroPharma, Inc., a Takeda company, and Meritage Pharma, Inc. (now part of Shire). Some authors declared serving as consultants for or receiving research funding, etc., from Meritage, Shire, and others. Four authors declared being employees and stockholders of Takeda.

Source: Mukkada VA et al. Pooled phase 2 and 3 efficacy and safety data on budesonide oral suspension in adolescents with eosinophilic esophagitis. J Pediatr Gastroenterol Nutr. 2023;77(6):760-768 (Sep 18). doi: 10.1097/MPG.0000000000003948

Key clinical point: In adolescents and adults with eosinophilic esophagitis (EoE), 300 mg dupilumab per week was effective and well-tolerated regardless of prior exposure to swallowed topical corticosteroids (STC).

Major finding: At week 24, a significantly higher proportion of patients receiving dupilumab vs placebo with (>50% vs ≤5%; P < .0001) or without (>45% vs ≤25%; P < .05) prior exposure to STC achieved a peak esophageal intraepithelial eosinophil count of ≤6 eosinophils per high-power field, with the improvements being maintained till week 52. No new adverse events were reported.

Study details: This sub-group analysis of the phase 3 LIBERTY EoE TREET study included 321 patients with EoE who were randomly assigned to receive dupilumab or placebo for 24 weeks, after which 304 patients received dupilumab for 28 weeks additionally.

Disclosures: This study was funded by Sanofi and Regeneron Pharmaceuticals Inc. Seven authors declared being employees or stockholders of Regeneron Pharmaceuticals or Sanofi. The other authors declared ties with various sources, including Sanofi and Regeneron.

Source: Bredenoord AJ et al. Dupilumab demonstrated efficacy and was well tolerated regardless of prior use of swallowed topical corticosteroids in adolescent and adult patients with eosinophilic oesophagitis: A subgroup analysis of the phase 3 LIBERTY EoE TREET study. Gut. 2023 (Nov 27). doi: 10.1136/gutjnl-2023-330220

Key clinical point: In adolescents and adults with eosinophilic esophagitis (EoE), 300 mg dupilumab per week was effective and well-tolerated regardless of prior exposure to swallowed topical corticosteroids (STC).

Major finding: At week 24, a significantly higher proportion of patients receiving dupilumab vs placebo with (>50% vs ≤5%; P < .0001) or without (>45% vs ≤25%; P < .05) prior exposure to STC achieved a peak esophageal intraepithelial eosinophil count of ≤6 eosinophils per high-power field, with the improvements being maintained till week 52. No new adverse events were reported.

Study details: This sub-group analysis of the phase 3 LIBERTY EoE TREET study included 321 patients with EoE who were randomly assigned to receive dupilumab or placebo for 24 weeks, after which 304 patients received dupilumab for 28 weeks additionally.

Disclosures: This study was funded by Sanofi and Regeneron Pharmaceuticals Inc. Seven authors declared being employees or stockholders of Regeneron Pharmaceuticals or Sanofi. The other authors declared ties with various sources, including Sanofi and Regeneron.

Source: Bredenoord AJ et al. Dupilumab demonstrated efficacy and was well tolerated regardless of prior use of swallowed topical corticosteroids in adolescent and adult patients with eosinophilic oesophagitis: A subgroup analysis of the phase 3 LIBERTY EoE TREET study. Gut. 2023 (Nov 27). doi: 10.1136/gutjnl-2023-330220

Key clinical point: In adolescents and adults with eosinophilic esophagitis (EoE), 300 mg dupilumab per week was effective and well-tolerated regardless of prior exposure to swallowed topical corticosteroids (STC).

Major finding: At week 24, a significantly higher proportion of patients receiving dupilumab vs placebo with (>50% vs ≤5%; P < .0001) or without (>45% vs ≤25%; P < .05) prior exposure to STC achieved a peak esophageal intraepithelial eosinophil count of ≤6 eosinophils per high-power field, with the improvements being maintained till week 52. No new adverse events were reported.

Study details: This sub-group analysis of the phase 3 LIBERTY EoE TREET study included 321 patients with EoE who were randomly assigned to receive dupilumab or placebo for 24 weeks, after which 304 patients received dupilumab for 28 weeks additionally.

Disclosures: This study was funded by Sanofi and Regeneron Pharmaceuticals Inc. Seven authors declared being employees or stockholders of Regeneron Pharmaceuticals or Sanofi. The other authors declared ties with various sources, including Sanofi and Regeneron.

Source: Bredenoord AJ et al. Dupilumab demonstrated efficacy and was well tolerated regardless of prior use of swallowed topical corticosteroids in adolescent and adult patients with eosinophilic oesophagitis: A subgroup analysis of the phase 3 LIBERTY EoE TREET study. Gut. 2023 (Nov 27). doi: 10.1136/gutjnl-2023-330220

Key clinical point: The use of antibiotics and acid-suppressants during the prenatal period and infancy increased the risk of developing eosinophilic esophagitis (EoE) later in life.

Major finding: The risk for EoE increased by 50% in offsprings who were administered antibiotics during the prenatal period (adjusted odds ratio [aOR] 1.5; 95% CI 1.2-1.9); moreover, the administration of antibiotics (aOR 1.4; 95% CI 1.1-1.7) and acid-suppressants (aOR 15.9; 95% CI 9.1-27.7) in infancy was significantly associated with an increased risk for EoE.

Study details: Findings are from a case-control study including 392 children with EoE and 3637 age- and sex-matched control individuals without EoE.

Disclosures: This study was supported by a grant from the US National Institutes of Allergy and Infectious Diseases. Some authors declared receiving grants, consulting fees, or funding from various sources.

Source: Jensen ET et al. Maternal and infant antibiotic and acid suppressant use and risk of eosinophilic esophagitis. JAMA Pediatr. 2023;177(12):1285-1293 (Oct 30). doi: 10.1001/jamapediatrics.2023.4609

Key clinical point: The use of antibiotics and acid-suppressants during the prenatal period and infancy increased the risk of developing eosinophilic esophagitis (EoE) later in life.

Major finding: The risk for EoE increased by 50% in offsprings who were administered antibiotics during the prenatal period (adjusted odds ratio [aOR] 1.5; 95% CI 1.2-1.9); moreover, the administration of antibiotics (aOR 1.4; 95% CI 1.1-1.7) and acid-suppressants (aOR 15.9; 95% CI 9.1-27.7) in infancy was significantly associated with an increased risk for EoE.

Study details: Findings are from a case-control study including 392 children with EoE and 3637 age- and sex-matched control individuals without EoE.

Disclosures: This study was supported by a grant from the US National Institutes of Allergy and Infectious Diseases. Some authors declared receiving grants, consulting fees, or funding from various sources.

Source: Jensen ET et al. Maternal and infant antibiotic and acid suppressant use and risk of eosinophilic esophagitis. JAMA Pediatr. 2023;177(12):1285-1293 (Oct 30). doi: 10.1001/jamapediatrics.2023.4609

Key clinical point: The use of antibiotics and acid-suppressants during the prenatal period and infancy increased the risk of developing eosinophilic esophagitis (EoE) later in life.

Major finding: The risk for EoE increased by 50% in offsprings who were administered antibiotics during the prenatal period (adjusted odds ratio [aOR] 1.5; 95% CI 1.2-1.9); moreover, the administration of antibiotics (aOR 1.4; 95% CI 1.1-1.7) and acid-suppressants (aOR 15.9; 95% CI 9.1-27.7) in infancy was significantly associated with an increased risk for EoE.

Study details: Findings are from a case-control study including 392 children with EoE and 3637 age- and sex-matched control individuals without EoE.

Disclosures: This study was supported by a grant from the US National Institutes of Allergy and Infectious Diseases. Some authors declared receiving grants, consulting fees, or funding from various sources.

Source: Jensen ET et al. Maternal and infant antibiotic and acid suppressant use and risk of eosinophilic esophagitis. JAMA Pediatr. 2023;177(12):1285-1293 (Oct 30). doi: 10.1001/jamapediatrics.2023.4609