Histologic EoE control tied to lower chance of stricture development in children

Children with eosinophilic esophagitis (EoE) with a period of histologic disease control and diagnosed at younger ages appear to have reduced odds of developing esophageal strictures, according to a cohort study with >10 years of follow-up.

The authors identified participants using a database of paediatric patients with EoE at the Children’s Hospital of Philadelphia in the US starting in 2000. They then searched for patients in adult medical records to determine those who transitioned care.

The authors also reviewed all office visits, emergency department visits, and endoscopic, histologic, and imaging reports for stricture, the primary outcome, and food impactions and dysphagia, the secondary outcomes. These outcomes were assessed via Cox proportional hazard regression.

Overall, 105 patients were identified, with a mean follow-up of 11.4 years. More than half (n=55, 52.3 percent) had a period of histologic disease control, defined as two or more consecutive endoscopies with histologic remission.

These children with a history of histologic disease control were less likely to develop strictures relative to those who did not have a period of histologic control (hazard ratio, 0.232, 95 percent confidence interval, 0.084‒0.63; p=0.005). Similarly, patients diagnosed at a younger age had a lower rate of stricture development.

On the other hand, those who presented with dysphagia or impaction were more likely to develop strictures.

“While [the findings] suggest histologic remission is associated with reduction of remodeling complications, additional prospective data with long-term follow-up are needed,” the authors said.