Prevalence of eosinophilic esophagitis in a United States military health-care population

Ally, Mazer; Maydonovitch, Corinne; Betteridge, John; Veerappan, Ganesh R.; Moawad, Fouad J.

doi:10.1111/dote.12229

Cited by 33 publications

(38 citation statements)

References 30 publications

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“…In our study, we estimated the prevalence in children (under 18 yrs of age) to be 25.1/100,000. In the adult population (18–65 yrs of age), we estimated the prevalence of EoE at 30/100,000, while previous studies in literature have reported prevalence rates ranging from 9.5–56.7/100,000 [6,7,8,12,15,16,17]. Multiple factors likely contribute to the variation in prevalence rates among studies, some of which include methods of data collection, data analyses, case definition of EoE and regional variation of EoE.…”

Section: Discussionmentioning

confidence: 99%

“…Although there have been three recent epidemiological studies in EoE [7,16,17] utilizing large databases, we added previous proton-pump inhibitor (PPI) exposure to the case definition of EoE to exclude cases of PPI-responsive esophageal eosinophilia (PPI-REE) [1,18], to make our estimate of prevalence more precise. We sought to describe the epidemiology of EoE in the United States (US), and identify associated disorders by using a population-based database.…”

Section: Background and Aimsmentioning

confidence: 99%

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The 2010–2015 Prevalence of Eosinophilic Esophagitis in the USA: A Population-Based Study

Mansoor

Cooper

2016

Dig Dis Sci

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Background & Aims Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder with increasing prevalence. However, epidemiologic data has mostly been acquired from small studies. We sought to describe the epidemiology of EoE in the United States, utilizing a large database. Methods We queried a commercial database (Explorys Inc, Cleveland, OH), an aggregate of electronic health record data from 26 major integrated US healthcare systems from 1999 to July 2015. We identified an aggregated patient cohort of eligible patients with EoE and a history of proton pump inhibitor use between July 2010 to July 2015, based on Systematized Nomenclature Of Medicine – Clinical Terms (SNOMED-CT). We calculated the prevalence of EoE among different patient groups. Results Of the 30,301,440 individuals in the database, we identified 7,840 patients with EoE with an overall prevalence of 25.9/100,000 persons. Prevalence was higher in males than females (Odds Ratio [OR] 2.00; 95% CI=1.92–2.10, p<0.0001), Caucasians vs. African-Americans and Asians (OR 2.00; 95% CI: 1.86–2.14, p<0.0001) and adults (18–65yrs) vs. elderly (>65yrs) and children (<18yrs) (OR 1.63; 95% CI: 1.54–1.71, p<0.0001). Compared with controls (individuals in database without EoE), individuals with EoE were more likely to have other gastrointestinal diagnoses such as dysphagia and at least one allergic condition. Conclusions In this large study, we found that the estimated prevalence of EoE in the US is 25.9/100,000, which is at the lower end of prevalence rates reported in US and other industrial countries. We confirmed that EoE has a strong association with allergic and gastrointestinal diagnoses.

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Section: Discussionmentioning

confidence: 99%

Section: Background and Aimsmentioning

confidence: 99%

The 2010–2015 Prevalence of Eosinophilic Esophagitis in the USA: A Population-Based Study

Mansoor

Cooper

2016

Dig Dis Sci

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“…13,14 A study in the U.S. military found a prevalence of 10/100,000, but this might have been an underestimate due to the specialized population assessed or to low sensitivity of the administrative code for EoE. 66,69 Studies from the Netherlands and the southern region of Denmark have also reported lower prevalences of EoE. 21,64 It is unknown if these results are due to practice patterns in those countries or a true difference in the prevalence of disease.…”

Section: Prevalencementioning

confidence: 99%

Epidemiology of Eosinophilic Esophagitis

Dellon¹

2014

Gastroenterology Clinics of North America

268

222

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Great strides have been made in understanding the epidemiology of EoE over the past two decades. Initial research focused on case description and characterization of the burden of disease. Research is now shifting to risk factor ascertainment, resulting in new and intriguing etiologic hypotheses. This paper will review the current knowledge related to the epidemiology of EoE. Demographic features and natural history will be described, data summarizing the prevalence and incidence of EoE throughout the world will be highlighted, and risk factors for EoE will be discussed. EoE can occur at any age, there is a male predominance, it is more common in Whites, and there is a strong association with atopic diseases. EoE is chronic, relapses are frequent, and persistent inflammation increases the risk of fibrostenotic complications. The prevalence is currently estimated at 0.5–1 in 1000, and EoE is now the most common cause of food impaction. EoE can be seen in 2–7% of patients undergoing endoscopy for any reason, and 12–23% undergoing endoscopy for dysphagia. The incidence of EoE is approximately 1/10,000 new cases per year, and the rise in incidence is outpacing increases in recognition and endoscopy volume. The reasons for this evolving epidemiology are not yet fully delineated, but possibilities include changes in food allergens, increasing aeroallergens and other environmental factors, the decrease of H. pyloriand early life exposures.

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“…Nevertheless, a number of investigators have used a variety of strategies to report prevalence estimates ranging from less than 10 to more than 80 cases per 100,000. 5-15 The potential for estimating EoE prevalence at the national level was made possible in 2008 with the approval of an International Classification of Diseases, Ninth Revision (ICD-9) code for EoE (530.13). We have recently validated this code for use in administrative database research, and found that the specificity of the code was extremely high.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Eosinophilic Esophagitis in the United States

Dellon

Jensen

Martin

et al. 2014

Clinical Gastroenterology and Hepatology

398

297

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Background & Aims Eosinophilic esophagitis (EoE) has become a major cause of upper gastrointestinal morbidity in children and adults. However, there are few data on the nationwide prevalence of EoE. We aimed to estimate the prevalence of EoE in the United States (US). Methods We collected health insurance claims from a large database that represented the US commercially insured population. We analyzed data from 2008 through 2011, identifying cases of EoE using a previously validated definition, and calculated a period prevalence using data from 2009 through 2011. EoE was defined as any instance of the ICD-9 code 530.13. We calculated the prevalence of the code in the database and standardized the estimate to the US population. Results Of 35,575,388 individuals in this database, 16,405 had at least 1 code for EoE. The mean age was 33.5 y, 65% were male, 55.8% had dysphagia, and 52.8% had a diagnostic code for at least 1 allergic condition. Among 11,569,217 individuals with continuous insurance coverage between mid-2009 and mid-2011, 6513 had at least one code for EoE. When standardized to the US population, the estimated period prevalence of EoE was 56.7/100,000 persons, translating to approximately 152,152 cases in the US. Prevalence peaked in men 35–39 y old, with a rate of 114.6/100,000 persons. Conclusions Despite its relatively recent description, EoE is frequently diagnosed in the US, with an estimated prevalence of 56.7/100,000 persons. This estimate depends on the accuracy of the ICD-9 code, but could be an underestimate, given that knowledge of the code and recognition of EoE are increasing.

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Prevalence of eosinophilic esophagitis in a United States military health-care population

Cited by 33 publications

References 30 publications

The 2010–2015 Prevalence of Eosinophilic Esophagitis in the USA: A Population-Based Study

The 2010–2015 Prevalence of Eosinophilic Esophagitis in the USA: A Population-Based Study

Epidemiology of Eosinophilic Esophagitis

Prevalence of Eosinophilic Esophagitis in the United States

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