EoE Module 7 References-Armin et al Clin Gastroenterol Hepatol 2023 Monitoring patients with EoE in routine clinical practice International Expert Recommendations

Armin et al Clin Gastroenterol Hepatol 2023 Monitoring patients with EoE in routine clinical practice International Expert Recommendations

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The document presents international expert recommendations for monitoring patients with Eosinophilic Esophagitis (EoE) in routine clinical practice. A consortium of international experts formed groups to discuss key questions on why, how, and when to monitor EoE patients, given the lack of existing studies or guidance on optimal monitoring strategies. <br /><br />The recommendations emerged from consensus meetings, structured via the Delphi method, which involved a multi-step survey process leading to the development of statements on patient monitoring. Eighteen experts participated, each with at least 21.7 years of clinical practice, primarily from academic settings. They agreed upon an 11-statement guidance and a proposed algorithm for EoE monitoring, reaching over 75% consensus in a Delphi survey.<br /><br />EoE is a chronic, allergic condition of the esophagus marked by dense eosinophilic infiltration and symptoms do not correlate well with esophageal inflammation. Hence, routine follow-up should include symptom assessment, periodic endoscopy, and histological evaluations. Effective ongoing treatment potentially reduces complications like food bolus impaction and strictures.<br /><br />The experts underscore that maintenance treatment likely minimizes EoE complications. They advocate regular, structured follow-ups, tailored to individual circumstances, to assess disease activity, track treatment effects, and enhance therapy adherence. Recommended follow-up intervals include initial endoscopic checks 8 to 12 weeks after any significant treatment change, with subsequent follow-ups every 12 to 24 months, adaptable based on symptom changes or presence of strictures.<br /><br />The initiative also emphasizes on non-invasive monitoring methods like the Endoscopic Reference Score (EREFS) and esophageal string test but maintains more research is required before adopting these universally in clinical settings. This structured guidance aims to aid clinicians in managing EoE patients effectively, preventing disease progression and related complications.

Keywords

Eosinophilic Esophagitis

patient monitoring

Delphi method

clinical practice

endoscopy

histological evaluations

treatment adherence

EREFS

esophageal string test

disease management