An allergic phenotype and the use of steroid inhalers predict eosinophilic oesophagitis in patients with asthma. Issue 1 (8th November 2012)

• Record Type: Journal Article
• Authors: Harer, K. N.; Enders, F. T.; Lim, K. G.; Alexander, J. A.; Katzka, D. A.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 37:Issue 1(2013)
• Page Start: 107
• Page End: 113
• Publication Date: 2012-11-08
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.12131
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt12131-abs-0001"> <title>Summary</title> <sec id="apt12131-sec-0001" sec-type="section"> <title>Background</title> <p>Patients with eosinophilic oesophagitis (EoE) commonly have asthma and atopy.</p> </sec> <sec id="apt12131-sec-0002" sec-type="section"> <title>Aims</title> <p>To determine the predictive factors of EoE in patients with asthma.</p> </sec> <sec id="apt12131-sec-0003" sec-type="section"> <title>Methods</title> <p>A retrospective analysis of a large database identified 156 asthma patients with EoE and 276 patients without EoE between 2000 and 2010. Clinical and laboratory characteristics were first analyzed in half of each group. Significant differences and modelling were then applied to the other half of each group in a split half analysis.</p> </sec> <sec id="apt12131-sec-0004" sec-type="section"> <title>Results</title> <p>Odds ratios and <italic>P</italic>‐values found to predict the presence of EoE in asthma patients were: allergic vs. non‐allergic asthma (4.07, <0.01), food allergies (45, <0.01), allergic rhinitis (2.13, =0.01) and peripheral eosinophilia (4.51, <0.01). The use of inhaled corticosteroids was negatively associated with EoE (0.41, <0.01) for asthma patients and (0.37, <italic>P</italic> < 0.01) for allergic type asthma patients. EoE patients were also younger (27.4 vs. 41.6 years old, <italic>P </italic>< 0.01). By logistic regression analysis, allergic asthma, presence of peripheral eosinophilia and use of inhaled steroids remained significant. From these parameters, a 3.5‐point scoring system model for EoE in asthma was formed with an ROC = 0.787 on split analysis.</p> </sec> <sec id="apt12131-sec-0005" sec-type="section"> <title>Conclusions</title> <p>In descending order, peripheral eosinophilia, allergic asthma and allergic rhinitis are associated with EoE in patients with asthma. Steroid inhalers appear to have a protective effect against EoE. An accurate and simple scoring system can be used as a screening tool to predict the presence of EoE in patients with asthma and dysphagia. EoE should be viewed as part of a generalised allergic phenotype rather than isolated oesophageal disease.</p> </sec> </abstract>