Publicaciones científicas

Accurate and timely diagnosis of Eosinophilic Esophagitis improves over time in Europe. An analysis of the EoE CONNECT Registry

16-may-2022 | Revista: United European Gastroenterology Journal

Pilar Navarro  1   2   3 , Emilio J Laserna-Mendieta  1   2   3   4 , Sergio Casabona  2   5 , Edoardo Savarino  6 , María Teresa Pérez-Fernández  2   5 , Matteo Ghisa  6 , Isabel Pérez-Martínez  7   8 , Danila Guagnozzi  9   10 , Antonia Perelló  11 , Antonio Guardiola-Arévalo  12 , Francesca Racca  13 , Elena Betoré  14 , Leonardo Blas-Jhon  15 , Anne Lund Krarup  16 , Verónica Martín-Domínguez  2   5 , Daria Maniero  6 , Adolfo Suárez  7   8 , Ronald Llerena-Castro  9 , Luisa de la Peña-Negro  11 , Alicia Granja Navacerrada  12 , Gaia Pellegatta  17 , Javier Alcedo  14 , Lonore de Hurtado Mendoza-Guena  15 , Sara Feo-Ortega  4   18 , Jesús Barrio  19 , Carolina Gutiérrez-Junquera  20 , Sonia Fernández-Fernández  21 , Susana De la Riva  22 , Juan E Navés  23 , Silvia Carrión  10   24 , Constanza Ciriza de Los Ríos  25   26 , Natalia García-Morales  27 , Juan Armando Rodríguez-Oballe  28 , Raffaela Dainese  29 , Alba Rodríguez-Sánchez  30 , María Lluisa Masiques-Mas  31 , María Teresa Palomeque  32 , Cecilio Santander  2   5   10 , Sonsoles Tamarit-Sebastián  1   3 , Ángel Arias  2   4   10   33 , Alfredo J Lucendo  1   2   3   10


Background: Poor adherence to clinical practice guidelines for eosinophilic esophagitis (EoE) has been described and the diagnostic delay of the disease continues to be unacceptable in many settings.

Objective: To analyze the impact of improved knowledge provided by the successive international clinical practice guidelines on reducing diagnostic delay and improving the diagnostic process for European patients with EoE.

Methods: Cross-sectional analysis of the EoE CONNECT registry based on clinical practice. Time periods defined by the publication dates of four major sets of guidelines over 10 years were considered. Patients were grouped per time period according to date of symptom onset.

Results: Data from 1,132 patients was analyzed and median (IQR) diagnostic delay in the whole series was 2.1 (0.7-6.2) years. This gradually decreased over time with subsequent release of new guidelines (p < 0.001), from 12.7 years up to 2007 to 0.7 years after 2017.

The proportion of patients with stricturing of mixed phenotypes at the point of EoE diagnosis also decreased over time (41.3% vs. 16%; p < 0.001), as did EREFS scores. The fibrotic sub-score decreased from a median (IQR) of 2 (1-2) to 0 (0-1) when patients whose symptoms started up to 2007 and after 2017 were compared (p < 0.001). In parallel, symptoms measured with the Dysphagia Symptoms Score reduced significantly when patients with symptoms starting before 2007 and after 2012 were compared.

A reduction in the number of endoscopies patients underwent before the one that achieved an EoE diagnosis, and the use of allergy testing as part of the diagnostic workout of EoE, also reduced significantly over time (p = 0.010 and p < 0.001, respectively).

Conclusion: The diagnostic work-up of EoE patients improved substantially over time at the European sites contributing to EoE CONNECT, with a dramatic reduction in diagnostic delay.

CITA DEL ARTÍCULO  United European Gastroenterol J. 2022 Jun;10(5):507-517. doi: 10.1002/ueg2.12240. Epub 2022 May 16.