ArticleThe American journal of gastroenterology2015
Long-Term Loss of Response in Proton Pump Inhibitor-Responsive Esophageal Eosinophilia Is Uncommon and Influenced by CYP2C19 Genotype and Rhinoconjunctivitis.
Article in The American journal of gastroenterology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 4 of them syntheses that pooled it.
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Who cites it
59 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Pooled it
- Technical Review on the Management of Eosinophilic Esophagitis: A Report From the AGA Institute and the Joint Task Force on Allergy-Immunology Practice Parameters.Gastroenterology · 2020Guideline
- Updated International Consensus Diagnostic Criteria for Eosinophilic Esophagitis: Proceedings of the AGREE Conference.Gastroenterology · 2018Guideline
- Guideline
- Advances in Management of Eosinophilic Esophagitis in Pediatrics.Paediatric drugs · 2026Review
- Optimizing proton-pump inhibitor therapy in paediatric eosinophilic esophagitis throughJournal of the Canadian Association of Gastroenterology · 2025Article
- Eosinophilic Esophagitis: Prevalence, Diagnosis, and Treatment in Childhood and Adulthood.Deutsches Arzteblatt international · 2025Review
- Monitoring of Maintenance Therapy in Eosinophilic Esophagitis: Listen, Look, and Touch.Digestive diseases and sciences · 2025Article
- Real world treatment patterns in patients with eosinophilic esophagitis in Japan.Scientific reports · 2024Article
- EoE Recurrence on PPI Maintenance Therapy: You Do Not Know if You Do Not Look!Digestive diseases and sciences · 2024Article
- Diagnosis and management of eosinophilic esophagitis and esophageal food impaction in adults : A position paper issued by the Austrian Society of Gastroenterology and Hepatology (ÖGGH).Wiener klinische Wochenschrift · 2024Article
- Long-term Outcome of Asymptomatic Esophageal Eosinophilia.Gut and liver · 2024Article
- Eosinophilic esophagitis: Current concepts in diagnosis and management.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2024Review
- Proton-Pump Inhibitors in Eosinophilic Esophagitis: A Review Focused on the Role of Pharmacogenetics.Pharmaceutics · 2024Review
- Allergic phenotype identified on allergen testing is associated with proton pump inhibitor nonresponse in eosinophilic esophagitis.Journal of gastroenterology and hepatology · 2024Article
- Eosinophilic esophagitis in the "atopic march": dupilumab as an "umbrella" strategy for multiple coexisting atopic diseases.Frontiers in medicine · 2024Review
- Optimal Assessment, Treatment, and Monitoring of Adults with Eosinophilic Esophagitis: Strategies to Improve Outcomes.ImmunoTargets and therapy · 2024Review
- Proton Pump Inhibitors in Allergy: Benefits and Risks.The journal of allergy and clinical immunology. In practice · 2022Review
- Risk of fractures in individuals with eosinophilic esophagitis: nationwide population-based cohort study.Esophagus : official journal of the Japan Esophageal Society · 2022Article
- Long-term efficacy of proton pump inhibitors as a treatment modality for eosinophilic esophagitis.Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2022Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesProton pump inhibitor-responsive esophageal eosinophilia (PPI-REE) is diagnosed in at least one-third of patients with suspected eosinophilic esophagitis (EoE). We aimed to evaluate the durability and factors influencing long-term efficacy of PPI therapy.
methodsRetrospective multicenter cohort study of patients with PPI-REE who had at least 12 months of follow-up. PPI therapy was tapered to the lowest dose, which maintained clinical remission. Primary outcomes were the proportion of patients with loss of histological response (<15 eos/HPF) and predictors of loss of response. CYP2C19 polymorphisms were determined from blood samples in a subset of patients.
resultsSeventy-five PPI-REE patients were included (mean follow-up 26 months (12-85)), of whom fifty-five (73%) had sustained histological remission on low-dose PPI therapy. Loss of response was significantly higher in those patients with a CYP2C19 rapid metabolizer genotype (36% vs. 6%, P = 0.01) and with rhinoconjunctivitis (40% vs. 13%, P = 0.007). On the multivariate analysis, a CYP2C19 rapid metabolizer genotype (odds ratio (OR) 12.5; 95% confidence interval (CI): 1.3-115.9) and rhinoconjunctivitis (OR 8.6; 95% CI: 1.5-48.7) were independent predictors of loss of response. Among relapsing patients, eosinophilia was limited to the distal esophagus in 14/20 (70%). Nine of ten relapsers, with distal eosinophilia, all showing a CYP2C19 rapid metabolizer genotype, regained histological remission after PPI dose intensification.
conclusionsMost PPI-REE patients remain in long-term remission on low-dose PPI therapy. CYP2C19 rapid metabolizer genotypes and rhinoconjunctivitis were independent predictors of loss of response to PPI, but patients frequently responded to PPI dose escalation.
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