Patient-Reported Outcomes in Eosinophilic Esophagitis and Achalasia

Schoepfer, Alain; Straumann, Alex; Safroneeva, Ekaterina

doi:10.1007/s11938-016-0084-0

Cited by 5 publications

(7 citation statements)

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“…Esophageal diseases, especially EE, can be assessed by the means of patient-related outcome (PRO) and clinician-reported outcome (ClinRO) measures. PRO incorporates various measures of symptom severity, functioning (disability), health status, health-specific quality of life, ‘general’ quality of life, and general health perceptions [15, 16]. Various PRO instruments have been developed and validated for the assessment of EE—especially clinical response to treatment, including the Eosinophilic Esophagitis Activity Index (EEsAI) and Dysphagia Symptom Questionnaire (DSQ).…”

Section: Introductionmentioning

confidence: 99%

“…Various PRO instruments have been developed and validated for the assessment of EE—especially clinical response to treatment, including the Eosinophilic Esophagitis Activity Index (EEsAI) and Dysphagia Symptom Questionnaire (DSQ). Several factors are incorporated in the EEsAI tool that assess dysphagia, behavioral adaptation to dysphagia, and pain with swallowing [17], while the DSQ has been shown to be content valid and is currently being further evaluated in a number of trials [16].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and Safety of Budesonide in the Treatment of Eosinophilic Esophagitis: Updated Systematic Review and Meta-Analysis of Randomized and Non-Randomized Studies

et al. 2018

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Background and ObjectiveEosinophilic esophagitis (EE) is an immune/antigen-driven inflammation that causes esophageal dysfunction. Budesonide has shown promising effect in the management of EE in multiple studies, and we therefore conducted this systematic review/meta-analysis to assess budesonide efficacy and safety in order to provide more updated and robust evidence.MethodsIn April 2018, we conducted a systematic electronic search through four databases: PubMed, Scopus, Web of Science (ISI), and Cochrane Central. All original studies reporting the efficacy of budesonide in the treatment of EE were included in our meta-analysis. The Cochrane Collaboration tool was employed to assess the risk of bias among included randomized controlled trials, while the Newcastle–Ottawa Scale was used for non-randomized studies.ResultsA total of 12 studies including 555 participants were included in our review. Budesonide showed marked efficacy at the level of histological response compared to placebo [risk ratio (RR) (95% confidence interval (CI)) 11.93 (4.82–29.50); p > 0.001]. Analysis of randomized and non-randomized studies revealed considerable reduction in eosinophil count, with a mean difference (MD) (95% CI) of − 69.41 (− 105.31 to − 33.51; p < 0.001) and 46.85 (33.93–59.77; p < 0.001), respectively. Similarly, there was a marked improvement in the clinical symptoms via the analysis of randomized and non-randomized studies, with an RR (95% CI) of 1.72 (1.22–2.41; p = 0.002) and MD (95% CI) of 2.45 (0.76–4.15; p = 0.005), respectively.ConclusionBudesonide showed significant effect at all treatment endpoints. However, since budesonide carries a risk of candidiasis and our inferences are based only on a small number of included studies, more research is warranted to clarify these results.Electronic supplementary materialThe online version of this article (10.1007/s40268-018-0253-9) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Budesonide in the Treatment of Eosinophilic Esophagitis: Updated Systematic Review and Meta-Analysis of Randomized and Non-Randomized Studies

et al. 2018

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“…These instruments aim to enhance patient-reported data quality in medical research and regulatory decision-making. PRO measures, self-reported by patients, assess symptom severity, healthrelated quality of life, general quality of life, or health status [22].…”

Section: Role Of Assessment Toolsmentioning

confidence: 99%

“…Validated instruments for assessing the severity of EoE symptoms and quality of life are now available. These validated instruments contribute to improved clinical assessments and research in EoE management and patient care [22]. However, the panel emphasized the need for further research to validate the use of these instruments in EoE assessment (level of evidence: 5; grade of evidence: D).…”

Section: Role Of Assessment Toolsmentioning

confidence: 99%

Expert Recommendations on the Diagnosis of Eosinophilic Esophagitis in the United Arab Emirates

Awadhi,

Miqdady,

Abuzakouk

et al. 2024

Cureus

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Eosinophilic esophagitis (EoE) is a chronic, progressive, type 2 inflammatory esophageal disease presenting as dysphagia to solid food and non-obstructive food impaction. Knowledge gaps exist in its diagnosis and management. These expert recommendations focused on the diagnosis of EoE in the United Arab Emirates.An electronic search of PubMed and Embase databases was used to gather evidence from systematic reviews, randomized controlled trials, consensus papers, and expert opinions from the last five years on the diagnosis of EoE. The evidence was graded using the Oxford system. Literature search findings were shared with the expert panel. A 5-point scale (strongly agree, agree, neither agree nor disagree, disagree, and strongly disagree) was used, and a concordance rate of >75% among experts indicated agreement. Using a modified Delphi technique, 18 qualified experts provided 17 recommendations.Eleven statements achieved high agreement, four got moderate agreement, and two got low agreement. Challenges exist in diagnosing EoE, particularly in children. Esophageal biopsies were crucial in diagnosis, irrespective of visible mucosal changes. Further research on diagnostic tools like endoscopic mucosal impedance and biomarkers is needed. Diagnosis relies on esophageal biopsies and symptom-histology correlation; however, tools like EoE assessment questionnaires and endoscopic mucosal impedance could enhance the accuracy and efficiency of EoE diagnosis.The diagnosis of EoE is challenging since the symptoms seldom correlate with the histological findings. Currently, diagnosis is based on patient symptoms and endoscopic and histological findings. Further research into mucosal impedance tests and the role of biomarkers is needed to facilitate diagnosis.

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“…The PRO measures are those that are designed to be self-reported by patients. Commonly used PRO instruments include those that assess symptom severity, health-related quality of life, “general” quality of life, or health status [32]. Timed barium esophagogram and Eckardt score may be used in the initial evaluation of patients with simultaneous achalasia and EoE in order to diagnose and evaluate achalasia severity before and after treatment [31].…”

Section: Implications and Future Perspectives In Diagnosis And Treatmentmentioning

confidence: 99%

Eosinophilic Esophagitis and Achalasia: Two Distinct Nosologic Entities or a Possible Etiopathogenic Association?

Schizas¹,

Syllaios²,

Vailas³

et al. 2021

Dig Dis

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Background: Despite the fact that researchers have made significant progress in elucidating pathophysiology of esophageal diseases, the understanding of esophageal motility alterations in patients with eosinophilic esophagitis is in its infancy and current published medical literature remains rather scarce on this topic. A growing body of scientific data regarding associations between esophageal motor disorders such as achalasia and eosinophilic esophagitis exists nowadays. Summary: It seems that association of eosinophilic esophagitis and achalasia does not constitute a cause and effect relationship, as it is not clear whether esophageal motility abnormalities are the result of eosinophilic esophagitis or vice versa. As such, there is no universally accepted treatment algorithm for patients presenting with both of these entities. Key messages: The aim of this article is to review the existing data on achalasia-like motility disorders in patients with eosinophilic esophagitis, highlighting possible association between these two esophageal disorders. Moreover, we seek to describe the clinical presentation in such cases, diagnostic modalities to be used and current treatment strategies in patients suspected to suffer from both disorders.

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Patient-Reported Outcomes in Eosinophilic Esophagitis and Achalasia

Cited by 5 publications

References 46 publications

Efficacy and Safety of Budesonide in the Treatment of Eosinophilic Esophagitis: Updated Systematic Review and Meta-Analysis of Randomized and Non-Randomized Studies

Efficacy and Safety of Budesonide in the Treatment of Eosinophilic Esophagitis: Updated Systematic Review and Meta-Analysis of Randomized and Non-Randomized Studies

Expert Recommendations on the Diagnosis of Eosinophilic Esophagitis in the United Arab Emirates

Eosinophilic Esophagitis and Achalasia: Two Distinct Nosologic Entities or a Possible Etiopathogenic Association?

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