Importance of assessing key disease domains in EOE
WHY IS IT IMPORTANT TO ASSESS MULTIPLE DISEASE DOMAINS IN EoE?
Outcomes from different disease domains may be discordant with one another14
- Symptoms may persist and fibrotic changes may still occur despite histologic remission 9,15,16
- Symptoms may not be present despite endoscopic and histologic evidence of inflammation3
- Subtle esophageal findings of EoE may not be recognized by the less-experienced endoscopist and routine endoscopic findings alone may not detect sections of reduced luminal diameter and microscopic inflammation, thereby requiring additional histologic assessments 9,14,15,17,18
- EoE specific QoL assessments may not correlate with mild forms of endoscopic features of EoE and basal layer hyperplasia, thus requiring confirmation from endoscopic and histologic findings 3
Comprehensive assessment using symptoms and QoL, histology, and endoscopy, enables an individualized, patient-centric approach to the management of EoE7,9,11,15
*Symptoms image reprinted with permission from Springer Nature, Clinical Reviews in Allergy and Immunology, Gonsalves N, Eosinophilic Gastrointestinal Disorders, Vol. 57/No. 2, Copyright 2019. Endoscopy image reprinted with permission from Springer Nature, Nature Reviews Gastroenterology & Hepatology, Biedermann L and Straumann A, Mechanisms and clinical management of eosinophilic oesophagitis: an overview, Vol. 20/No. 2, Copyright 2023. Histology image reprinted from Bystrom J, O'Shea NR. Postgrad Med J. 2014;90(1063):282-289. This is an open access article under the CC BY-NC 3.0 license (https:// creativecommons.org/licenses/by-nc/3.0/legalcode).
*EoE, eosinophilic esophagitis; eos/hpf, eosinophils per high-power field; QoL, quality of life.
1. Gonsalves N. Clin Rev Allergy Immunol. 2019;57(2):272-285. 2. Lucendo AJ, et al. United European Gastroenterol J. 2017;5(3):335-358. 3. Safroneeva E, et al. Aliment Pharma Ther. 2015;42:1000-1010. 4. Hewett R, et al. Dis Esophagus. 2017;30(1):1-7. 5. Lucendo AJ, et al. United European Gastroenterol J. 2018;6(1):38-45. 6. Pokrzywinski RM, et al. Adv Ther. 2020;37:4458-4478. 7. Dellon ES, et al. Gastroenterology. 2022;163(1):59-76. 8. Biedermann L, Straumann A. Nat Rev Gastroenterol Hepatol. 2023;20(2):101-119. 9. Aceves SS, et al. Gastrointest Endosc. 2022;96(4):576-592.e1. 10. Bystrom J, O'Shea NR. Postgrad Med J. 2014;90(1063):282-289. 11. Ma C, et al. J Allergy Clin Immunol. 2022;149(2):659-670. 12. Lyons E, et al. Gastroenterology. 2019;157(2):275- 277. 13. Hirano I, Aceves SS. Gastroenterol Clin North Am. 2014;43(2):297-316. 14. Hirano I, et al. Gastroenterology. 2020;158:1776-1786. 15. von Arnim U, et al. Clin Gastroenterol Hepatol. 2022;S1542-3565(22)01185-5. 16. Safroneeva E, et al. Gastroenterology. 2016;150(3):581-590.e4. 17. Dellon ES, et al. Gastroenterology. 2018;155(4):1022-1033. 18. Lynch KL, et al. Clin Transl Gastroenterol. Published online January 5, 2023. doi: 10.14309/ctg.0000000000000564.