P2232 - Family History of Eosinophilic Esophagitis or Other Eosinophilic Gastrointestinal Disease Is Not Associated With Non-Response to Topical Steroid Treatment in Eosinophilic Esophagitis

Angela Z. Xue, MD, MPH¹, Sean S. LaFata, BS¹, Tim S. Gee, BS¹, Hannah L. Thel, BS¹, Brenderia A. Cameron, MS¹, Akshatha Kiran, MD, MPH², Adolfo A. Ocampo, MD, MA¹, Justin McCallen, MD¹, Christopher J. Lee, MD¹, Stephanie A. Borinsky, MD, MSCR¹, Walker D. Redd, MD¹, Trevor Barlowe, MD¹, Rayan N. Kaataki, MD¹, Cary C. Cotton, MD, MPH¹, Swathi Eluri, MD, MSCR³, Craig C. Reed, MD, MSCR¹, Evan S.. Dellon, MD, MPH, FACG^1
1University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC; ²University of North Carolina at Chapel Hill, Chapel Hill, NC; ³Mayo Clinic, Jacksonville, FL

Introduction: Few data assess the impact of family history of EoE or other eosinophilic gastrointestinal diseases (EGID) on EoE presentation or treatment response. We aimed to investigate whether clinical features at diagnosis or topical steroid (tCS) treatment response varies among patients with and without a family history of EoE or other EGID.

Methods: In this retrospective cohort study of, we analyzed patients of any age with a new diagnosis of EoE. Family history of EoE or EGID, demographics, symptom response, and endoscopic findings were extracted from the electronic medical record. For patients who had documented treatment with a tCS and a follow-up endoscopy with biopsy, histologic response was defined as < 15 eos/hpf, with additional assessment of ≤6 and < 1 eos/hpf. Global symptomatic response, endoscopic response, EREFS, and endoscopic severity score (ESS) were also obtained. We compared baseline characteristics and post-tCS treatment response between patients with and without a family history of EoE/EGID.

Results: Of 1305 participants included, 49 (4%) had a family history of EoE/EGID. Patients with a family history of EoE/EGID were more likely to be younger (21.5y ± 17.0 vs 28.5y ± 19.0, p=0.01), be insured (96% vs 82%, p=0.02), have lower BMI (21.3 ± 5.6 vs 24.6 ± 7.1, p=0.004), have atopic conditions (76% vs 57%, p=0.02), and present with vomiting (41% vs 24%, p=0.009). On endoscopy, those with a family history of EoE/EGID were more likely to have furrows (82% vs 31%, p=0.03) and lower total EREFS (2.8 ± 1.7 vs 3.6 ± 1.9, p=0.02). However, multivariate analysis revealed none of the above risk factors was independently associated with a positive family history of EoE/EGID. For patients treated with tCS, the type of tCS used and the mean steroid dose were similar between patients with and without a family history of EoE/EGID (Figure). Patients with a family history of EoE/EGID were more likely to have normal endoscopic findings (44% vs 22%, p=0.02), and less likely to have esophageal rings (17% vs 44%, p=0.02) post-tCS treatment than those without (Figure).

Discussion: EoE patients with a family history of EoE/EGID had similar presentations compared to those without after adjusting for covariates. Though EoE patients with a family history were more likely to have a normal endoscopy after tCS treatment, family history was not a risk factor for symptomatic or histologic non-response to tCS.



Disclosures:


Angela Z. Xue, MD, MPH¹, Sean S. LaFata, BS¹, Tim S. Gee, BS¹, Hannah L. Thel, BS¹, Brenderia A. Cameron, MS¹, Akshatha Kiran, MD, MPH², Adolfo A. Ocampo, MD, MA¹, Justin McCallen, MD¹, Christopher J. Lee, MD¹, Stephanie A. Borinsky, MD, MSCR¹, Walker D. Redd, MD¹, Trevor Barlowe, MD¹, Rayan N. Kaataki, MD¹, Cary C. Cotton, MD, MPH¹, Swathi Eluri, MD, MSCR³, Craig C. Reed, MD, MSCR¹, Evan S.. Dellon, MD, MPH, FACG¹. P2232 - Family History of Eosinophilic Esophagitis or Other Eosinophilic Gastrointestinal Disease Is Not Associated With Non-Response to Topical Steroid Treatment in Eosinophilic Esophagitis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.