Proton pump inhibitor therapy reverses endoscopic features of fibrosis in eosinophilic esophagitis
| Autor: | Pedro Majano, Antonia Perelló, Edoardo Savarino, Matteo Ghisa, Danila Guagnozzi, Pilar Navarro, Cecilio Santander, Guillermo Ortega-Rabbione, Emilio J Laserna-Mendieta, Ángel Arias, Susana de la Riva, Carmen Alcolea-Valero, Natalia Serrano-Moya, Sergio Casabona, Alfredo J. Lucendo, José María Olalla |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Proton pump inhibitors/therapeutic use Swallowed topic steroids Gastroenterology Endosonography 03 medical and health sciences 0302 clinical medicine Fibrosis Internal medicine Disease management medicine Humans In patient Registries Eosinophilic esophagitis Adrenal cortex hormones/therapeutic use Retrospective Studies Hepatology Adult patients medicine.diagnostic_test business.industry Remission Induction Endoscopy Proton Pump Inhibitors Middle Aged medicine.disease Cross-Sectional Studies 030220 oncology & carcinogenesis Esophageal Stenosis Female 030211 gastroenterology & hepatology Proton pump inhibitor therapy business |
| Zdroj: | Digestive and Liver Disease. 53:1479-1485 |
| ISSN: | 1590-8658 |
| Popis: | Long-standing inflammation leads to esophageal remodeling with stricture formation in patients with eosinophilic esophagitis (EoE). The ability of proton pump inhibitors (PPI) to reverse endoscopic features of fibrosis is still unknown.To investigate the effect of a short course of PPI treatment in reducing endoscopic findings indicative of esophageal fibrosis in EoE patients.Cross-sectional analysis of the EoE CONNECT registry. Patients who received PPI to induce EoE remission were evaluated. Endoscopic features were graded using the EoE Endoscopic Reference Score (EREFS), with rings and strictures indicating fibrosis. Results were compared to those from patients treated with swallowed topic corticosteroids (STC).Clinico-histological remission was achieved in 83/166 adult patients treated with PPI (50%) and in 65/79 (82%) treated with STC; among responders, 60 (36%) and 57 (72%) patients respectively achieved deep histological remission (5 eosinophils/hpf). At baseline, mean±SD EREFS was lower in patients treated with PPI compared to those who received STC (p 0.001). Short term treatment significantly reduced EREFS scores in patients treated either with PPI or STC as well as rings and strictures. Among patients treated with PPI, deep histological remission (5 eosinophils/hpf) provided further reduction in total EREFS score.Effective PPI therapy for EoE significantly reduced endoscopic esophageal fibrosis in the short term. |
| Databáze: | OpenAIRE |
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