EoE Module 7 References-Dellon et al Gastroenterology 2022 A clinical severity index for EoE Development consensus and future directions

Dellon et al Gastroenterology 2022 A clinical severity index for EoE Development consensus and future directions

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The development of a Clinical Severity Index for Eosinophilic Esophagitis (EoE) aims to standardize the assessment of EoE's severity, thus improving the consistency of treatment and management across healthcare providers. EoE is a chronic immune/antigen-mediated esophageal disease characterized by eosinophilic infiltration and symptoms of esophageal dysfunction. There has been a substantial increase in the understanding of EoE over the past few decades, transforming it from a little-known condition to a well-characterized disease. However, despite advancements, variability in diagnosis and management practices persists.<br /><br />The proposed Index of Severity for Eosinophilic Esophagitis (I-SEE) intends to provide a systematic approach to assessing EoE severity by combining key clinical features, including symptoms, endoscopic and histological findings, and treatment responsiveness. I-SEE categorizes EoE severity into three levels: mild (0–6 points), moderate (7–14 points), and severe (≥15 points). The index is developed by an international collaboration of experts and serves as a tool for clinicians to use in routine clinical settings to evaluate disease progression and guide therapeutic decisions.<br /><br />The severity index will be used to monitor disease trajectory over time, prompting necessary adjustments in treatment and monitoring based on changes in severity. It combines elements such as symptom frequency, endoscopy (edema, furrows, and exudates), histological features (eosinophil count, basal zone hyperplasia, and lamina propria fibrosis), and complications such as food impaction and hospitalization.<br /><br />Future directions emphasize validating I-SEE through clinical trials and real-world application to ensure its effectiveness and adaptability in different clinical practices. This initiative seeks to improve patient care, facilitate communication between healthcare providers, and align treatment strategies with disease severity, ultimately enhancing outcomes for patients with EoE.

Keywords

Clinical Severity Index

Eosinophilic Esophagitis

EoE

I-SEE

esophageal dysfunction

disease severity

endoscopic findings

histological features

treatment responsiveness

patient care