The management and course of eosinophilic oesophagitis in Israeli children

Rosen, Irit; Mahamed, Aos; Garah, Jamal; Magen‐Rimon, Ramit; Shaoul, Ron

doi:10.1111/apa.15746

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…The reported summary statistic is the back-transformed inverse-variance weighted average for histologic remission across all studies listed in children. References: Sayej, 2009, 21 Dranove, 2009, 20 Schroeder, 2013, 185 Rea, 2013, Gutiérrez-Junquera, 2016, 187 Gómez-Torrijos, 2018, 188 Harris, 2018, 213 Vieira, 2020, 189 Rosen, 2021 214 . …”

Section: Ppi Efficacy In Childrenmentioning

confidence: 99%

Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis: History, Mechanisms, Efficacy, and Future Directions

Franciosi¹,

Mougey²,

Dellon³

et al. 2022

JAA

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Over the past decade, the role of proton pump inhibitor (PPI) medication has evolved from a diagnostic tool for Eosinophilic Esophagitis (EoE), by excluding patients with PPI responsive esophageal eosinophilia (PPI-REE), to a therapy for EoE. This transition resulted from the Updated International Consensus Diagnostic Criteria for Eosinophilic Esophagitis: Proceedings of the Appraisal of Guidelines for Research and Evaluation II (AGREE) Conference to support PPI therapy for EoE in children and adults. Additional recent advances have suggested a role for genetic variations that might impact response to PPI therapy for EoE. This review article will explore a brief background of EoE, the evolution of PPI therapy for EoE and its proposed mechanisms, efficacy and safety in children and adults, and considerations for future PPI precision medicine in patients with EoE.

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Section: Ppi Efficacy In Childrenmentioning

confidence: 99%

Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis: History, Mechanisms, Efficacy, and Future Directions

Franciosi¹,

Mougey²,

Dellon³

et al. 2022

JAA

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“…The higher percentage of positive clinical responses among patients receiving acid-blocking drugs compared to our study may be related to the study population (Asian vs. Caucasian). However, in other studies PPIs were less effective in the induction of a clinical response than an elimination diet or topical steroids [10,16].…”

Section: Discussionmentioning

confidence: 90%

“…The prevalence and incidence of EoE in children have continued to rise, according to population-based studies, and vary significantly between studies [1,[7][8][9]. There are very limited data referring to the natural history of paediatric EoE [10][11][12][13][14]. Monitoring paediatric patients diagnosed with EoE is extremely important and requires not only clinical evaluation, but also repeated endoscopies and oesophageal biopsies based on recent recommendations.…”

Section: Introductionmentioning

confidence: 99%

Treatment effectiveness in paediatric patients with eosinophilic oesophagitis

Zdanowicz¹,

Kucharska²,

Lebensztejn³

et al. 2022

polp

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Introduction: An increase in the incidence of eosinophilic oesophagitis (EoE) in children is being observed worldwide. The diagnosis is confirmed by the morphological examination of the mucosa biopsies. The aim of our study was to evaluate the clinical course of EoE in the first year of diagnosis, and the effectiveness of the first-line treatment of EoE in children. Material and methods:This single-centre retrospective study included children with EoE newly diagnosed between January 2015 and December 2020. Patients were monitored after initial treatment and 12 months after diagnosis. The study assessed clinical, endoscopic, and histological responses to various therapeutic strategies. Results: Of the 27 children diagnosed with EoE, 19 were enrolled in the study. The median age of children with EoE was 9 years (range 2-17 years) and the majority were male (84.2%). The most frequent initial treatments were proton pump inhibitors (PPIs) (47.4%), also in combination with an elimination diet (36.8%). Clinical improvement was noted in 73.7% of cases after initial therapy and in 84.2% of patients after 12-month follow-up. However, endoscopic and histological improvement was observed less frequently, in 52.6% and 47.4% of patients, respectively. Forty-two per cent of children with EoE obtained clinical, endoscopic, and histological improvement, and the majority of them received PPIs in mono-or combination therapy with an elimination diet. Conclusions: Choosing an effective treatment that provides clinical, endoscopic, and histological improvement in patients with EoE is a challenge for clinicians. According to our observations, clinical improvement should not be a single indicator of treatment success; therefore, it is necessary to repeat upper endoscopy and oesophageal biopsy.

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“…The impression from reviwing all the medical records is that Danish clinicians are reluctant to prescribe topical corticosteroids to children. This is unfortunate as topical corticosteroids are very effective with few and mild side effects e.g., oral candidiasis but not growth retardation, adrenal insufficiency, diabetes or osteoporosis [ 10 , 23 , 30 ]. Treatment with topical corticosteroids was only started if parents were recommended this by a specialist, indicating that EoE treatment would benefit from standardizing treatment in Denmark using a nationally recognized guideline.…”

Section: Discussionmentioning

confidence: 99%

There is a long way from current clinical practice in Denmark compared to recent published English guideline on management of children with eosinophilic oesophagitis

Bredal,

Frandsen,

Terkelsen

et al. 2024

BMC Pediatr

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Background A low incidence of eosinophilic esophagitis (EoE) in children in the North Denmark Region (NDR) were measured in 2007–2017. Few of the children diagnosed before 2017 were treated to remission suggesting a lack of awareness. While there currently are no guidelines for treating EoE in Denmark, a new English guideline was published in 2022 renewing focus on the disease. Objective The aim of this study was to measure the difference of current Danish clinical practice for treatment and follow-up of EoE children in the NDR with the new English guideline from the British Society of Gastroenterology (BSG) and the British Society of Pediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN). Methods This retrospective, register-based DanEoE cohort study included 31 children diagnosed with EoE between 2007 and 2021 in NDR. Medical records were reviewed and information about treatment and follow-up were collected. Results In 32% of the children with EoE in the NDR, first-line treatment corresponded with the new English guideline. One in 6 children were never started on any treatment even though treatment always is recommended. Histologic evaluation within 12 weeks as recommended was performed in 13% of the children. Conclusions In Denmark focus on improving EoE treatment and follow-up for children is needed, as there is a significant difference between current clinical practice and the recommendations in the new English guideline.

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The management and course of eosinophilic oesophagitis in Israeli children

Cited by 4 publications

References 19 publications

Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis: History, Mechanisms, Efficacy, and Future Directions

Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis: History, Mechanisms, Efficacy, and Future Directions

Treatment effectiveness in paediatric patients with eosinophilic oesophagitis

There is a long way from current clinical practice in Denmark compared to recent published English guideline on management of children with eosinophilic oesophagitis

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