CEGIR 2019 Publication Highlights

Question

Accepted Answer

Association Between Endoscopic and Histologic Findings in a Multicenter Retrospective Cohort of Patients with Non-esophageal Eosinophilic Gastrointestinal Disorders.

Dig Dis Sci. 2019 Nov 26. doi: 10.1007/s10620-019-05961-4.

CEGIR researchers set out to characterize the endoscopic and histologic findings in children and adults with eosinophilic gastritis (EG), eosinophilic gastroenteritis (EGE), and eosinophilic colitis (EC) at the time of diagnosis and 6 months after the start of therapy.

“Of the 29% of subjects with post-treatment follow-up, most had an improvement in clinical, endoscopic, and histologic findings regardless of treatment utilized,” the authors noted. “Reductions in tissue eosinophilia correlated with improvements in clinical symptoms as well as endoscopic and histologic findings.”

Investigators concluded that the most common endoscopic finding was a normal appearance, which underscores the importance of biopsy even if the tissue appears visually normal during endoscopy.

“Decreased tissue eosinophilia was associated with improvement in symptoms, endoscopic, and histologic findings, showing that disease activity is reversible,” they also concluded.

Molecular, Endoscopic, Histologic and Circulating Biomarker-Based Diagnosis of Eosinophilic Gastritis: Multi-Site Study.

J Allergy Clin Immunol. 2019 Nov 15. pii: S0091-6749(19)31519-2. doi: 10.1016/j.jaci.2019.11.007.

In this publication, researchers describe their methodology and results of their work to develop tissue- and blood-based diagnostic platforms for eosinophilic gastritis EG.

“We developed tissue- and blood-based platforms for assessment of EG and uncovered robust associations between specific gastric molecular profiles and histologic and endoscopic features, providing insight and tools for this emerging rare disease,” they concluded.

Increasing Rates of Diagnosis, Substantial Co-Occurrence, and Variable Treatment Patterns of Eosinophilic Gastritis, Gastroenteritis, and Colitis Based on 10-Year Data Across a Multicenter Consortium.

Am J Gastroenterol. 2019 Jun;114(6):984-994. doi: 10.14309/ajg.0000000000000228.

In this retrospective study, researchers aimed to characterize rates of diagnosis, clinical features, and initial treatments for patients with eosinophilic gastritis (EG), eosinophilic gastroenteritis (EGE), and eosinophilic colitis (EC)

Investigators analyzed data from six centers in the Consortium of Eosinophilic Gastrointestinal Researchers from 2005-2016. In addition to demographics, time trends in diagnosis, medical history, presenting symptoms, disease overlap, and initial treatment patterns/responses were analyzed.

Some of the highlights of their findings include:

Rates of diagnosis of all diseases increased over time.

The majority of subjects had allergic conditions.

- - Presenting symptoms were similar between the diseases. The most common symptoms noted were nausea/vomiting and abdominal pain.
  - 41% of the patients in this cohort had eosinophilic inflammation outside of their primary disease location. Children more commonly had multi-site inflammation (68% vs 37%).
  - Initial treatment strategies varied greatly between centers.
  - Twenty-nine percent of the patients had follow-up within 6 months, and the majority had clinical, endoscopic, and histologic improvements.

The authors noted in their conclusion, “Future investigation should assess the cause of the increased prevalence of eosinophilic GI disorders and prospectively assess outcomes to establish treatment algorithms.”

Consortium of Eosinophilic Gastrointestinal Disease Researchers: Advancing the Field of Eosinophilic GI Disorders Through Collaboration.
Gastroenterology, March 2019;156:838–842

Dr. Sandeep Gupta, et al. published an article in the journal Gastroenterology reviewing current CEGIR projects, which included updates on the OMEGA study (Outcome Measures for Eosinophilic Gastrointestinal Diseases across Ages) and the SOFEED trial (Six Food versus One Food Eosinophilic Esophagitis Elimination Diet).

The article also discusses four novel pilot studies:

- investigating the use of losartan in patients who have eosinophilic esophagitis
- elemental diets in eosinophilic gastritis patients,
- transnasal endoscopies for monitoring EoE,
- and gaining further knowledge of the microbiome found in eosinophilic gastrointestinal disorders (EGIDs).

Highlights of CEGIR Publications