EoE ToT Module 2 References-Limketkai et al Gut 2018 Epidemiology and implications of concurrent diagnosis of EoE and IBD based on a prospective population based analysis

Limketkai et al Gut 2018 Epidemiology and implications of concurrent diagnosis of EoE and IBD based on a prospective population based analysis

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This study investigates the epidemiology and clinical implications of concurrent eosinophilic oesophagitis (EoO) and inflammatory bowel disease (IBD) diagnoses using the Truven MarketScan database. The study found a significantly higher incidence and prevalence of EoO among patients with Crohn's disease (CD) and ulcerative colitis (UC), and vice versa. Specifically, the incidence rates of EoO, CD, and UC in the general population were 23.1, 51.2, and 55.2 per 100,000 person-years, respectively. The incidence of EoO was higher in patients with CD (IRR 5.4, PR 7.8) and UC (IRR 3.5, PR 5.0), while the incidence of IBD was also higher in patients with EoO (CD: IRR 5.7, PR 7.6; UC: IRR 3.4, PR 4.9).<br /><br />The study observed that concurrent EoO and IBD diagnoses were associated with a greater risk of IBD-related complications but a lower risk of EoO-related complications. Specifically, patients with concurrent diagnoses had an increased risk of needing systemic corticosteroids for IBD treatment but either a decreased or unchanged risk of biological therapy initiation or IBD-related hospitalization. Conversely, EoO patients with IBD had a reduced risk of food bolus impaction and oesophageal stricture requiring endoscopic dilatation.<br /><br />Results suggest that EoO and IBD share overlapping pathogenic mechanisms and phenotypic manifestations. The study highlights the need for further research to elucidate shared determinants and mechanisms, which could potentially lead to better prevention, treatment, and reduction of disease-related complications for both EoO and IBD. The study's findings are significant as they highlight an emerging relationship between these two conditions, which has important clinical and therapeutic implications.

Keywords

epidemiology

eosinophilic oesophagitis

EoO

inflammatory bowel disease

IBD

Crohn's disease

ulcerative colitis

concurrent diagnoses

complications

pathogenic mechanisms