Close follow-up in EoE means fewer strictures
SAN DIEGO — Strictures related to eosinophilic esophagitis form less frequently in patients who are able to stick to a close follow-up schedule, according to research presented at Digestive Disease Week.
Thomas Greuter, MD, of the department of gastroenterology and hepatology at the University of Zurich Hospital in Switzerland, said patients with EoE who cease treatment can relapse relatively quickly, so it is important to keep close contact with them to maintain therapy.
“We know from other diseases that patients with long-term treatment need some sort of surveillance,” Greuter said. “However, as of yet, there are no evidence-based recommendations regarding the optimal follow-up in patients with [EoE].”
Researchers used cohorts from two large EoE referral centers to evaluate a long-term surveillance concept. Both centers — one in Switzerland and one in the United States — assessed clinical, endoscopic and histologic disease yearly regardless of EoE symptoms.
They analyzed data from 197 patients on a maintenance steroid therapy who they classified as either close follow-up with a duration between visits less than 18 months and non-close follow-up, who had visits at least 18 months apart. Of 336 total visits, 169 were within the 18-month timeframe (50.3%).
Patients in both groups had similar rates of adherence to prescribed treatment, and there was no difference between both groups in terms of clinical, endoscopic, histologic or complete remission.
However, researchers observed less stricture formation among the group in the close follow-up group (22.6%) compared with non-close group (32.5%; P = .043). Of 74 patients who achieved histologic remission and had at least one additional follow-up, 53 had a close follow-up schedule. Researchers were able to detect histologic relapse earlier in patients with a close follow-up schedule (1.1 year vs. 4.7 years; P < .001).
Greuter said less strictures and early recognition of relapse had a clear benefit for patients in the form of no increase in unnecessary procedures.
“We advocate for regular assessment of disease activity in order to detect relapsing disease as early as possible, which might minimize the risk for disease complications in the future,” he concluded. – by Alex Young
Reference:
Greuter T, et al. Abstract 358. Presented at: Digestive Disease Week; May 18-21, 2019; San Diego.
Disclosures: Greuter reports financial ties to Novartis Foundation and Sanofi Aventis. Please see the meeting disclosure index for all other authors’ relevant financial disclosures.
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