Sex-related differences in the presentation, management and response to treatment of eosinophilic esophagitis: Cross sectional analysis of EoE CONNECT registry.

Autor: Laserna-Mendieta EJ; Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain.; Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Madrid, Spain.; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Madrid, Spain., Casabona-Francés S; Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.; Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain., Amorena E; Department of Gastroenterology, Complejo Universitario de Navarra, Pamplona, Spain., Savarino EV; Surgery, Oncology and Gastroenterology, Gastroenterology Unit, Azienza Ospedaliera di Padova, Padova, Italy., Pérez-Martínez I; Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain.; Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain., Blas-Jhon L; Department of Gastroenterology, Fundación Jiménez Díaz, Madrid, Spain., Guardiola-Arévalo A; Department of Gastroenterology, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain., Coletta M; Department of Gastroenterology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy., Pellegatta G; Endoscopy Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy., Guagnozzi D; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Madrid, Spain.; Department of Gastroenterology, Hospital Universitario Vall d'Hebrón, Barcelona, Spain., Barrio J; Department of Gastroenterology, Hospital Universitario Rio Hortega, Valladolid, Spain., Perello A; Department of Gastroenterology, Hospital Universitari Son Espases, Palma de Mallorca, Spain., Betoré E; Department of Gastroenterology, Hospital Universitario Miguel Servet, Zaragoza, Spain., Krarup AL; Department of Emergency Medicine and Trauma Center, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Institute of Clinical Medicine Aalborg University, Aalborg, Denmark., Votto M; Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy., Gutiérrez-Junquera C; Department of Pediatric Gastroenterology, Hospital Universitario Puerta de Hierro, Majadahonda, Spain., Naves JE; Department of Gastroenterology, Hospital del Mar, Barcelona, Spain., Oliva S; Department of Pediatric Digestive Endoscopy, University Hospital Umberto I & Sapienza University of Rome, Rome, Italy., Teruel Sánchez-Vegazo C; Department of Gastroenterology, Hospital Universitario Ramón y Cajal, Madrid, Spain., Carrión S; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Madrid, Spain.; Department of Gastroenterology, Hospital de Mataró, Mataró, Spain., Riva S; Department of Gastroenterology, Clínica Universidad de Navarra, Pamplona, Spain., Espina-Cadenas S; Department of Gastroenterology, Hospital General de la Defensa, Zaragoza, Spain., Fernández-Fernández S; Gastroenterología infantil, Hospital Universitario severo Ochoa, Leganés, Madrid, Spain., Llorente-Barrio M; Department of Gastroenterology, Hospital de Santa Bárbara, Soria, Spain., Pascual-Lopez I; Department of Gastroenterology, Hospital Universitario Arnau de Vilanova & Hospital Universitario Santa María, Lérida, Spain., Masiques-Mas ML; Department of Pediatric Gastroenterology, Hospital de Granollers, Granollers, Spain., Honrubia-López R; Department of Gastroenterology, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Spain., Dainese R; Department of Gastroenterology, Centre Hospitalier d'Antibes Juan-les-Pins, Antibes, France., García-Morales N; Department of Gastroenterology, Hospital Álvaro Cunquerio, Vigo, Spain., Cobian J; Department of Gastroenterology, Hospital Donostia, San Sebastián, Spain., Bisso-Zein JK; Department of Gastroenterology, Hospital Costa del Sol, Marbella, Spain., Roales V; Department of Gastroenterology, Hospital Clínico Universitario San Carlos, Madrid, Spain., Juan-Juan A; Department of Gastroenterology, Hospital Sant Joan Despí Moisès Broggi, Barcelona, Spain., Rodríguez-Sánchez A; Department of Gastroenterology, Hospital Universitario Santa Lucía, Cartagena, Spain., Feo-Ortega S; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Madrid, Spain.; Department of Pediatrics, Hospital General de Tomelloso, Tomelloso, Spain., Martín-Domínguez V; Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.; Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain., Nantes-Castillejo Ó; Department of Gastroenterology, Complejo Universitario de Navarra, Pamplona, Spain.; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain., Nicolay-Maneru J; Department of Gastroenterology, Complejo Universitario de Navarra, Pamplona, Spain., Ghisa M; Surgery, Oncology and Gastroenterology, Gastroenterology Unit, Azienza Ospedaliera di Padova, Padova, Italy., Maniero D; Surgery, Oncology and Gastroenterology, Gastroenterology Unit, Azienza Ospedaliera di Padova, Padova, Italy., Suarez A; Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain.; Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain., Maray I; Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.; Department of Pharmacy, Hospital Universitario Central de Asturias, Oviedo, Spain., Álvarez-García M; Department of Gastroenterology, Fundación Jiménez Díaz, Madrid, Spain., Granja-Navacerrada A; Department of Gastroenterology, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain., Penagini R; Department of Gastroenterology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy., Racca F; Personalized Medicine, Asthma and Allergy Clinic, IRCCS Humanitas Research Hospital, Rozzano - Milan, Italy., Llerena-Castro R; Department of Gastroenterology, Hospital Universitario Vall d'Hebrón, Barcelona, Spain., Santander C; Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Madrid, Spain.; Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain., Arias Á; Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Madrid, Spain.; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Madrid, Spain.; Research Support Unit, Hospital General La Mancha Centro, Alcázar de San Juan, Spain., Lucendo AJ; Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain.; Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Madrid, Spain.; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Madrid, Spain.
Jazyk: angličtina
Zdroj: United European gastroenterology journal [United European Gastroenterol J] 2024 Dec; Vol. 12 (10), pp. 1388-1398. Date of Electronic Publication: 2024 Nov 08.
DOI: 10.1002/ueg2.12699
Abstrakt: Background: Eosinophilic esophagitis (EoE) predominantly affects males across all ages; however, little is known about sex differences for other aspects of EoE.
Objective: To investigate associations between sex and clinical presentation, endoscopic features, treatment choice and response in EoE patients in real-world practice.
Methods: Cross-sectional analysis of the multicenter EoE CONNECT registry. The independent contribution of patients' sex and other relevant variables were statistically assessed by multivariate models.
Results: A total of 2976 patients (76% male) were evaluated. Males were diagnosed at a younger age compared to females (32.7 ± 14.8 vs. 34.8 ± 15.6 years, respectively; p = 0.002) with similar diagnostic delay. EoE symptoms varied significantly between sexes, with food impaction predominating in males and dysphagia, heartburn, regurgitation and abdominal and epigastric pain in females. However, female sex contributed to higher symptom severity at diagnosis as measured with Dysphagia Symptom Score (R 2  = 0.57; p = 0.013) and presented higher peak eosinophil count in esophageal biopsies (p = 0.005). Males showed increased risk of stricturing or mixed phenotypes (adjusted OR 1.43, 95%CI:1.05-1.96; p = 0.024). No association was found between patients' sex and first-line treatment modality: proton pump inhibitors (PPI) were preferred over topical corticosteroids in patients with inflammatory phenotypes instead of stricturing or mixed phenotypes, and in patients who did not present food impaction. Both topical corticosteroids and dietary interventions were preferred over PPI in pediatric patients regardless of sex.
Conclusions: Sex is associated with clinical and phenotypical presentation of EoE at diagnosis, with more fibrotic findings in males but higher symptom score in females.
(© 2024 The Author(s). United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)
Databáze: MEDLINE
Externí odkaz: