Proton Pump Inhibitors Produce Durable Response for Almost 2 of 3 Patients With Eosinophilic Esophagitis

Just under two-thirds of patients with eosinophilic esophagitis who showed an initial response to proton pump inhibitor therapy maintained that response after several years of treatment, according to findings published in Digestive and Liver Disease.

“Proton pump inhibitors are a first-line treatment for eosinophilic esophagitis, but data are limited concerning response durability,” wrote a research team from the University of North Carolina School of Medicine. “We aimed to determine long-term outcomes in eosinophilic esophagitis patients responsive to proton pump inhibitor therapy.”

The retrospective cohort study included 138 adults newly diagnosed with eosinophilic esophagitis who had an initial histologic response to proton pump inhibitors. Among them, 50 had long-term endoscopic follow-up, 40 had clinical follow-up, 10 changed treatments, and 38 had no long-term follow-up.

Over an average 3.6 ± 2.9 years for patients with endoscopic follow-up, 60% maintained histologic response and 64% maintained symptom response, according to the study.

Nevertheless, fibrotic endoscopic findings of eosinophilic esophagitis did not change.

Factors associated with histologic loss of response were younger age and dilation at baseline, researchers reported.

“These data,” they advised, “can inform long-term eosinophilic esophagitis treatment selection.”

Reference:
Thakkar KP, Fowler M, Keene S, Iuga A, Dellon ES. Long-term efficacy of proton pump inhibitors as a treatment modality for eosinophilic esophagitis. Dig Liver Dis. Published online April 8, 2022. doi:10.1016/j.dld.2022.03.006