ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2015
Predictors of response to steroid therapy for eosinophilic esophagitis and treatment of steroid-refractory patients.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 70 papers, 5 of them syntheses that pooled it.
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Who cites it
70 citing papers in PubMed, 5 syntheses or guidelines pooled it, 102 citations in OpenAlex.
- Systematic Review: Variability in Definitions of Fibrostenosis in Eosinophilic Oesophagitis.Alimentary pharmacology & therapeutics · 2025Pooled it
- Efficacy and Safety of Monoclonal Antibodies for the Treatment of Eosinophilic Esophagitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Digestive diseases and sciences · 2024Pooled it
- Systematic review and meta-regressions: management of eosinophilic esophagitis requires histologic assessment.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2018Pooled it
- Six-Food Elimination Diet and Topical Steroids are Effective for Eosinophilic Esophagitis: A Meta-Regression.Digestive diseases and sciences · 2017Pooled it
- Role of endoscopic esophageal dilation in managing eosinophilic esophagitis: A systematic review and meta-analysis.Medicine · 2017Pooled it
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- Utility of major basic protein, eotaxin-3, and mast cell tryptase staining for prediction of response to topical steroid treatment in eosinophilic esophagitis: analysis of a randomized, double-blind, double dummy clinical trial.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2020Trial
- A Novel Allergen-Specific Immune Signature-Directed Approach to Dietary Elimination in Eosinophilic Esophagitis.Clinical and translational gastroenterology · 2019Trial
- Efficacy of Budesonide vs Fluticasone for Initial Treatment of Eosinophilic Esophagitis in a Randomized Controlled Trial.Gastroenterology · 2019Trial
- Diffuse esophageal eosinophilia is associated with increased endoscopic severity and topical steroid non-response in patients with eosinophilic esophagitis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Article
- Eosinophilic gastrointestinal diseases.Nature reviews. Disease primers · 2026Review
- Replication of Endotypes in Eosinophilic Esophagitis Using a Curated Gene Panel Compared to Bulk Sequencing and Assessing Stability Over Time.Clinical and translational gastroenterology · 2026Article
- Single-cell transcriptomics reveals anti-inflammatory effects of prednisolone on the hepatic niche in biliary atresia.Scientific reports · 2026Article
- Roles of systemic CD4Research square · 2026Article
- Emerging Tissue and Blood Biomarkers for Eosinophilic Esophagitis.Gastroenterology clinics of North America · 2026Review
- Differences in Presentation and Outcomes by Type and Severity of Food Impaction Symptoms in Eosinophilic Esophagitis.Digestive diseases and sciences · 2026Article
- Variability in time to surveillance endoscopy for eosinophilic esophagitis remission and relation to treatment outcomes.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Article
- Overlapping type 2, barrier, and remodeling endotypes shape clinical expression in eosinophilic esophagitis.Frontiers in immunology · 2026Review
- Increasing Social Vulnerability Impacts Presentation and Decreases Treatment Response in Eosinophilic Esophagitis.Gastro hep advances · 2026Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
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- Erratum issuedDosage error in article text
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND &
aimsEosinophilic esophagitis (EoE) is commonly treated with swallowed (topical) corticosteroids (tCS). However, few factors have been described that predict outcomes of steroid therapy. We aimed to identify factors associated with nonresponse to tCS and report outcomes of second-line treatment for patients with steroid-refractory EoE.
methodsWe performed a retrospective cohort study by using the University of North Carolina EoE Clinicopathologic Database to identify patients who received tCS for EoE from 2006 through 2013. Demographic, symptom, endoscopic, and histologic data were extracted from medical records. Immunohistochemistry was performed on archived biopsies. Responders and nonresponders to tCS were compared.
resultsOf 221 patients with EoE who received tCS, 71% had endoscopic improvement, 79% had symptomatic improvement, and 57% had histologic response (<15 eosinophils/high-power field). After multivariate logistic regression, esophageal dilation at the baseline examination predicted nonresponse (odds ratio, 2.9; 95% confidence interval, 1.4-6.3), and abdominal pain predicted response (odds ratio for nonresponse, 0.31; 95% confidence interval, 0.12-0.83); no other clinical features were predictive. On the basis of immunohistochemical analysis, higher baseline levels of tryptase (244 vs 157 mast cells/mm(2), P = .04) and eotaxin-3 (2425 vs 239 cells/mm(2), P = .02) were associated with steroid response, but levels of major basic protein were not. Among 27 steroid-refractory patients, a mean of 2 additional therapies were tried; only 48% of the patients eventually responded to any second-line therapy.
conclusionsOn the basis of a retrospective analysis of a large group of patients with EoE, only 57% have a histologic response to steroid therapy. Baseline esophageal dilation and decreased levels of mast cells and eotaxin-3 predicted which patients would not respond to therapy. Combining clinical factors and immunohistochemistry might therefore be used to direct therapy.
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