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Steroid inhalers predict eosinophilic esophagitis in patients with asthma

An allergic phenotype and the use of steroid inhalers predict eosinophilic esophagitis in patients with asthma, reports a study in the Alimentary Pharmacology & Therapeutics, published ahead of print.

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Patients with eosinophilic esophagitis commonly have asthma and atopy.

To determine the predictive factors of eosinophilic esophagitis in patients with asthma.

Dr Harer reported that a retrospective analysis of a large database identified 156 asthma patients with eosinophilic esophagitis, and 276 patients without eosinophilic esophagitis between 2000 and 2010.

Clinical and laboratory characteristics were first analyzed in half of each group.

Significant differences and modelling were then applied to the other half of each group in a split half analysis.

The researchers found that the odds ratios and P-values found to predict the presence of eosinophilic esophagitis in asthma patients included allergic vs non-allergic asthma, food allergies, allergic rhinitis and peripheral eosinophilia.

The use of inhaled corticosteroids was negatively associated with eosinophilic esophagitis for asthma patients and for allergic type asthma patients.

Allergic rhinitis is associated with eosinophilic esophagitis in asthma
Alimentary Pharmacology & Therapeutics

Eosinophilic esophagitis patients were also younger.
 
The team of doctors found that allergic asthma, presence of peripheral eosinophilia and use of inhaled steroids remained significant.

From these parameters, a 3.5-point scoring system model for eosinophilic esophagitis in asthma was formed with an ROC = 0.80 on split analysis".

Dr Harer concludes, "In descending order, peripheral eosinophilia, allergic asthma and allergic rhinitis are associated with eosinophilic esophagitis in patients with asthma."

"Steroid inhalers appear to have a protective effect against eosinophilic esophagitis."

"An accurate and simple scoring system can be used as a screening tool to predict the presence of eosinophilic esophagitis in patients with asthma and dysphagia."

"Eosinophilic esophagitis should be viewed as part of a generalised allergic phenotype rather than isolated oesophageal disease."

Aliment Pharmacol Ther 2013: 37(1):107113)
12 December 2012

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