Eosinophilic esophagitis and inflammatory bowel disease have a connection in which patients with one are at higher risk for the other, according to research published in Gut.
“EoE and IBD are both chronic, often progressive, immune-mediated diseases of the luminal GI tract, with complex pathogeneses that implicate environmental factors, aberrant host immune responses and likely microbial factors, interacting on a background of genetic proclivity,” Jean-Frederic Colombel, MD, of the division of gastroenterology at the Icahn School of Medicine at Mount Sinai, and colleagues wrote. “Some overlap in pathogenesis and phenotype (eg, fibrostenotic Crohn’s disease and EoE esophageal stricture), thus seems plausible, although not yet well defined.”
Researchers conducted a prospective cohort analysis using the Truven MarketScan database from 2009 to 2016 to define the epidemiology and clinical implications of concurrent EoE and IBD diagnoses.
Among their cohort comprising 134,013,536 individuals, the incidence of EoE was 23.1 per 100,000 person-years, CD was 51.2 and ulcerative colitis was 55.2.
Compared with patients without either diagnosis, the risk for EoE was higher in patients with CD (IRR = 5.4, P < .01; prevalence ratio [PR] = 7.8, P < .01) and UC (IRR = 3.5, P < .01; PR = 5, P < .01). Meanwhile, the risk for IBD was higher among patients with EoE (CD: IRR = 5.7, P < .01; PR = 7.6, P < .01; UC: IRR = 3.4, P < .01; PR = 4.9, P < .01).
Additionally, researchers found that patients who had a concurrent diagnosis of EoE and IBD had a greater composite risk for IBD-related complications (CD: adjusted HR = 1.09, P = .01; UC: aHR = 1.1, P = .04). However, their composite risk for EoE-related complications was lower (aHR = 0.59, P < .01).
“Concurrent diagnosis of EoE and IBD also have clinical implications with respect to disease-related outcomes for both diseases,” Colombel and colleagues wrote. “Our findings clearly highlight the need for additional clinical and translational investigations to further unpack the relationship between these two diseases and to also externally validate our observations.” – by Alex Young
Disclosures: Colombel reports receiving research grants from AbbVie, Janssen and Takeda, as well as payments for lectures from AbbVie, Amgen, Ferring, Shire and Takeda, consulting fees from AbbVie, Amgen, Boehringer Ingelheim, Celgene, Celltrion, Enterome, Ferring, Genentech, Janssen, Eli Lilly, Mediummune, Merck, Novartis, Pfizer, Protagonist, Sandoz, Second Genome, Seres, Shire, Takeda, Theradiag and Theravance. He also reports holding stock options in Intestinal Biotech Development and Genfit. Please see the full study for all other authors’ relevant financial disclosures.