ArticleDigestive diseases and sciences2025
Histologic Response or Endoscopic Normalization After Initial Treatment for Eosinophilic Esophagitis in Children Leads to Less Fibrostenosis over Long-Term Follow-Up.
Article in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Eosinophilic esophagitis in children and adolescents: a clinical practice guideline.Italian journal of pediatrics · 2025Guideline
- Assessment, treatment, and prevention of complications in eosinophilic esophagitis.Foregut (Thousand Oaks, Calif.) · 2026Article
- Overlapping type 2, barrier, and remodeling endotypes shape clinical expression in eosinophilic esophagitis.Frontiers in immunology · 2026Review
- Endoscopic response to topical steroids is associated with a need for fewer future esophageal dilations.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2025Article
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Authors and funding
17 authors.
Funding
Abstract
backgroundUntreated eosinophilic esophagitis (EoE) can result in the development of fibrostenosis over time, but there are few data on whether successful treatment in childhood decreases this risk as children with EoE transition to adulthood.
aimTo determine whether histologic response or endoscopic normalization after EoE treatment is associated with decreased development of fibrostenosis.
methodsPediatric subjects were identified from a large EoE database at an academic referral center. Medical records were reviewed for the primary outcome of fibrostenosis, defined as esophageal stricture, narrowing, or dilation. We assessed the proportion of histologic responders and normal endoscopies at the first, second, and last esophagogastroduodenoscopy (EGD) on record following diagnosis. We created Kaplan-Meier curves to assess time to fibrostenosis and estimated hazard ratios using Cox proportional analysis.
resultsAmong 166 patients, the mean age at diagnosis was 10.2 years. Over a mean follow-up time of 4.7 ± 4.5 years, patients had an average of 4.3 ± 4.2 EGDs. The percent of patients with fibrostenosis was 9%, 15%, and 16% at first, second, and last EGD. Patients with histologic response at second follow-up developed fibrostenosis at a lower rate than non-responders (HR = 0.37, 95% CI 0.14-0.99), as did those with normal endoscopic findings at first follow-up (HR = 0.27, 95% CI 0.08-0.90).
conclusionsHistologic response and endoscopic normalization lead to lower rates of fibrostenosis in children with EoE. Though the development of fibrostenosis was relatively uncommon, occurring in < 20% of children with EoE who were followed long term, it is reasonable to target treatment goals of histologic response and endoscopic normalization.
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