TOP 11 - Evaluation of Factors Associated with Treatment Response in Pediatric Eosinophilic Esophagitis (EOE): A Retrospective Single Center Study

Publication Number: 2763.TOP 11

Erica R. Levin, Rutgers, Robert Wood Johnson Medical School, Pennington, NJ, United States; Gabrielle Ro, Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, United States; Melissa Weidner, Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, United States

Background: Eosinophilic esophagitis (EOE) is a chronic, immune-mediated disease of the esophagus. Clinically, patients present with symptoms of esophageal dysfunction and histologically with esophageal eosinophilia. Although EOE was first discovered in 1978, there remains a large gap in understanding factors associated with treatment response. There have been attempts to characterize EOE into phenotypes based on demographic, clinical, histologic and molecular factors, but data is limited. There is no known cure, and the prevalence of EOE is increasing.

Current treatments for EOE include proton-pump inhibitors (PPI), swallowed topical steroids (STC), dietary elimination, and the first FDA approved biologic for EOE, dupilumab (Dupixent). Currently, either PPI, dietary restriction, or STC are considered first-line treatment in pediatric EOE, and there is no data available regarding which single strategy has advantage as primary treatment. Treatment choice is personalized but often involves significant burden on the patient and their families with time spent trialing therapies and response measured through repeated invasive endoscopies. It is crucial to identify and understand phenotypes involved in EOE to guide treatment and reduce treatment-related burden on patients and their families.

Objective: The purpose of this study is to evaluate demographic and clinical factors associated with response to therapy in pediatric patients with EOE. We will determine initial response rates of pediatric EOE patients to different therapies within a cohort from a single center, Rutgers Robert Wood Johnson Pediatric Gastroenterology Group.

Design/Methods: Data was collected from patients diagnosed with EOE followed by the Rutgers Pediatric GI group over 10 years using EPIC electronic medical records, including results from initial and first follow-up endoscopy after treatment initiation. Demographic, clinical, endoscopic, and histologic variables were recorded. Patients will be stratified by treatment type, and characteristics will be compared between responders and those who maintain active disease to determine if there are phenotypic differences unique to either. We will examine which demographic and clinical factors, such as BMI z-score (or weight-for-length if < 2 years old), clinical symptoms, EREFS score, and peak eosinophil counts, at baseline or after treatment initiation, are associated with response to each therapy in patients with EOE. All data has been collected, and analysis is ongoing. GraphPad PRISM software will be used for analysis. The analysis will be complete by January 1st, 2026.

Patient demographics and clinical characteristics


Reported comorbidities and symptoms at initial presentation
Comorbidities (A) and initial symptoms (B) reported by pediatric patients with EOE at a single center (n= 126).