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Top EoE stories of 2014
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Numerous developments were made this year in eosinophilic esophagitis, or EoE. From new efficacy data on different treatments and diagnostic methods, to increased knowledge on dietary impacts and genetic epidemiology, the year’s emerging data on EoE were rich and diverse.
Here are the top EoE stories of 2014 presented by Healio Gastroenterology.
Genetics
Genetic, molecular etiology of EoE identified
Marc E. Rothenberg
Genetic contributors to the EoE disease process are linked to the CAPN14 gene that interacts with molecular allergic processes in esophageal epithelial tissue, according to recent study data.
“We have identified the genetic basis for EoE and in the process we uncovered part of the answer to a long-standing question in the allergy field: why patients develop certain manifestations of allergic disease, in this case the involvement of the esophagus,” Marc E. Rothenberg, MD, director of the Center for Eosinophilic Disorders at Cincinnati Children’s Hospital Medical Center, told Healio Gastroenterology. Read more
Environmental factors play bigger role than genetics in EoE
EoE has been shown to cluster in families, but new research demonstrated that much of this clustering can be attributed to common familial environmental factors.
“The power of this study is the twin analysis,” Eileen Alexander, PhD, MS, BSN, RN, Woodside Fellow at Cincinnati Children’s Hospital Medical Center (CCHMC), said in a press release. “Both the twin and family analyses support that genetics contribute to EoE risk, but the twin analysis revealed that the contribution of genetics was previously overestimated, masking the stronger contribution of common household environment.” Read more
Diet
Dietary elimination therapy improved symptoms of EoE
W. Asher Wolf
Dietary elimination therapy effectively reduced symptoms of EoE and improved endoscopic appearance in adult patients in a recent study.
“We've known for a while that dietary therapy works for children with EoE,” W. Asher Wolf, MD, MPH, division of gastroenterology and hepatology, University of North Carolina School of Medicine, told Healio Gastroenterology. “We are very happy to find that dietary therapy is also effective in adults.” Read more
Dietary intervention induced histologic remission of EoE
Dietary interventions, especially elemental diets and six-food elimination diets, were effective in inducing histologic remission in patients with EoE, according to recent study data.
“Our research has demonstrated that dietary modifications are an effective treatment alternative for inducing histologic remission of EoE, reinforcing the idea that this strategy should be considered as a first-line therapy in both children and adults affected by the disease,” the researchers wrote. Read more
EoE patients achieved remission with four-food group elimination diet
Adult patients with EoE achieved clinicopathologic remission with a four-food group elimination diet, according to research data.
“Three of every four patients achieving remission on a [six-food group elimination diet] may achieve it on a [four-food group elimination diet], a less restrictive dietary intervention that requires fewer endoscopies and shortens the food reintroduction process,” the researchers concluded. Read more
Therapeutics
Oral budesonide suspension reduced disease activity, symptoms of EOE
Oral budesonide suspension for the treatment of EoE reduced inflammation and dysphagia symptoms in a phase 2b trial, according to a Meritage Pharma press release.
“While previous studies have identified success in diminishing inflammation, this is the first study to show that a medication can significantly improve both symptoms and esophageal inflammation,” Glenn Furuta, MD, director of the gastrointestinal eosinophilic diseases program at Children’s Hospital Colorado and professor of pediatrics at the University of Colorado School of Medicine, said in the release. “These exciting results should provide new hope to those affected by EoE.” Read more
Oral budesonide suspension safely, effectively treated children with EoE
A new formulation of oral budesonide suspension was safe and effective for treatment of pediatric EoE, according to new research data.
“Oral budesonide suspension demonstrated remarkable efficacy to reduce eosinophilic inflammation in our study, offering hope for EoE patients,” Sandeep K. Gupta, MD, from Indiana University School of Medicine and Riley Hospital for Children, said. Read more
Diagnostics
Clinical features, biomarkers predicted steroid response in EoE
W. Asher Wolf
Need for esophageal dilation at baseline, abdominal pain at presentation and high esophageal tissue levels of eotaxin-3 and tryptase predicted response to topical corticosteroids in patients with EoE, according to new research data.
“While the majority of patients benefited from topical steroid therapy, nonresponse was common,” W. Asher Wolf, MD, MPH, from the University of North Carolina School of Medicine, and colleagues concluded. “There were few clinical, endoscopic, or histologic predictors of nonresponse, but the need for dilation at baseline was a strong independent predictor. Additionally, high esophageal tissue levels of eotaxin-3 and mast cells at baseline predicted treatment response, but this intriguing finding requires prospective confirmation before it can be adopted clinically.” Read more
Biomarkers diagnosed EoE, could not distinguish EoE from PPI-REE
Evan S. Dellon
Immunohistochemical analysis of major basic protein, eotaxin-3 and tryptase levels in esophageal tissues effectively diagnosed EoE, but could not differentiate the disease from proton pump inhibitor-responsive esophageal eosinophilia, according to new research data.
“The first main finding was that this set of esophageal biopsy stain clearly distinguished patients with EoE from those with GERD with a high degree of accuracy, essentially 100%,” Evan S. Dellon, MD, from the University of North Carolina School of Medicine, told Healio Gastroenterology. “The second main finding was that this set of stains did not distinguish EoE from PPI-REE.” Read more