Clinical Features and Treatment Response to Topical Steroids in Ethnic and Racial Minority Patients With Eosinophilic Esophagitis
INTRODUCTION:Differences in eosinophilic esophagitis (EoE) presentation and outcomes by ethnicity or race remain understudied. We aimed to determine whether EoE patients of Hispanic/Latinx ethnicity or non-White race have differences in presentation at diagnosis or response to topical corticosteroid...
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Published in | The American journal of gastroenterology Vol. 119; no. 2; pp. 262 - 269 |
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Main Authors | , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Philadelphia, PA
Wolters Kluwer
01.02.2024
Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins |
Subjects | |
Online Access | Get full text |
ISSN | 0002-9270 1572-0241 1572-0241 |
DOI | 10.14309/ajg.0000000000002532 |
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Summary: | INTRODUCTION:Differences in eosinophilic esophagitis (EoE) presentation and outcomes by ethnicity or race remain understudied. We aimed to determine whether EoE patients of Hispanic/Latinx ethnicity or non-White race have differences in presentation at diagnosis or response to topical corticosteroid (tCS) treatment.METHODS:This retrospective cohort study included subjects of any age with a new diagnosis of EoE and documentation of ethnicity or race. For those who had treatment with tCS and follow-up endoscopy/biopsy, we assessed histologic response (<15 eosinophils/hpf), global symptom response, and endoscopic response. Hispanic EoE patients were compared with non-Hispanics at baseline and before and after treatment. The same analyses were repeated for White vs non-Whites.RESULTS:Of 1,026 EoE patients with ethnicity data, just 23 (2%) were Hispanic. Most clinical features at presentation were similar to non-Hispanic EoE patients but histologic response to tCS was numerically lower (38% vs 57%). Non-White EoE patients (13%) were younger at diagnosis and had less insurance, lower zip code-level income, shorter symptom duration, more vomiting, less dysphagia and food impaction, fewer typical endoscopic features, and less dilation. Of 475 patients with race data treated with tCS, non-Whites had a significantly lower histologic response rate (41% vs 59%; P = 0.01), and odds of histologic response remained lower after controlling for potential confounders (adjusted odds ratio 0.40, 95% confidence intervals: 0.19-0.87).DISCUSSION:Few EoE patients at our center were Hispanic, and they had similar clinical presentations as non-Hispanics. The non-White EoE group was larger, and presentation was less dysphagia-specific. Non-White patients were also less than half as likely to respond to tCS. |
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Bibliography: | Correspondence: Evan S. Dellon MD, MPH. E-mail: edellon@med.unc.edu.SUPPLEMENTARY MATERIAL accompanies this paper at http://links.lww.com/AJG/D73 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Dellon: Project conception, study design, data collection, data analysis/interpretation, manuscript drafting, critical revision Author contributions (all authors approved the final manuscript) Xue, Chang, Thakkar, Reddy, Greenberg, Lee, Ketchem, Redd, Eluri, Reed: Data collection and interpretation, critical revision Ocampo: Study design, data collection and interpretation, manuscript drafting, critical revision |
ISSN: | 0002-9270 1572-0241 1572-0241 |
DOI: | 10.14309/ajg.0000000000002532 |