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The Predictive Factors of Responsiveness to Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis

Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan
Author to whom correspondence should be addressed.
Gastrointest. Disord. 2019, 1(1), 220-230;
Received: 10 January 2019 / Revised: 18 February 2019 / Accepted: 21 February 2019 / Published: 25 February 2019
Approximately half of patients with eosinophilic esophagitis (EoE) respond clinically and histologically to proton pump inhibitor (PPI) therapy. Although recent guidelines suggest that PPI-responders and non-responders were included in EoE, it is important to investigate the predictive factors of PPI- responsiveness. This study aimed to determine the rate of PPI- responders and compare the characteristics of PPI-responders and non-responders. Fifty-nine patients with esophageal eosinophilia received PPI therapy for eight weeks, and its efficacy was assessed. PPI- responsiveness was diagnosed based on the relief in symptoms and reduction of intraepithelial eosinophilic infiltration to <15 per high-power field (hpf) after PPI therapy. Multivariate analysis was performed to identify factors associated with PPI-responders. Of the 59 patients, 41 (69.5%) were diagnosed with PPI-responders. The rate of gastrointestinal (GI) screening in the indications for endoscopy was significantly higher in patients with PPI- responders than in those with non-responders. On multivariate analysis, GI screening and presence of reflux esophagitis was associated with an increased odds ratio (OR) of PPI-responders, but presence of rings with a decreased OR of PPI-responders. Presence of reflux esophagitis and absence of rings on endoscopy especially during GI screening might be significant predictive factors for PPI response in patients with EoE. View Full-Text
Keywords: esophagus; eosinophilic esophagitis; proton pump inhibitor esophagus; eosinophilic esophagitis; proton pump inhibitor
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Hashimoto, A.; Sugawa, T.; Iwakura, N.; Uemura, R.; Sawada, A.; Otani, K.; Taira, K.; Hosomi, S.; Nagami, Y.; Tanaka, F.; Kamata, N.; Yamagami, H.; Tanigawa, T.; Watanabe, T.; Fujiwara, Y. The Predictive Factors of Responsiveness to Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis. Gastrointest. Disord. 2019, 1, 220-230.

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