期刊
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
卷 150, 期 1, 页码 33-47出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2022.03.015
关键词
Eosinophilic esophagitis; severity; complications; symptoms; endoscopy; histology
资金
- American Gastroenterological Association (AGA)
- Takeda Pharmaceuticals USA, Inc.
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases/National Institutes of Health
- Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR) [U54 AI117804]
- Knighten Health, LLC
This study aimed to create an international consensus severity scoring index for eosinophilic esophagitis (EoE) in order to reduce variability in practice patterns among clinicians. The research team evaluated features related to histology, endoscopy, and symptoms and created a simplified scoring system that can be used during routine clinic visits.
Background & Aims: Disease activity and severity of eosinophilic esophagitis (EoE) dictate therapeutic options and management, but the decision-making process for determining severity varies among practitioners. To reduce variability in practice patterns and help clinicians monitor the clinical course of the disease in an office setting, we aimed to create an international consensus severity scoring index for EoE. Methods: A multidisciplinary international group of adult and pediatric EoE researchers and clinicians, as well as non-EoE allergy immunology and gastroenterology experts, formed 3 teams to review the existing literature on histology, endoscopy, and symptoms of EoE in the context of progression and severity. A steering committee convened a 1-day virtual meeting to reach consensus on each team's opinion on salient features of severity across key clinicopathologic domains and distill features that would allow providers to categorize disease severity. Results: Symptom features and complications and inflammatory and fibrostenotic features on both endoscopic and histologic examination were collated into a simplified scoring system-the Index of Severity for Eosinophilic Esophagitis (I-SEE)-that can be completed at routine clinic visits to assess disease severity using a point scale of 0-6 for mild, 7-14 for moderate, and >= 15 for severe EoE. Conclusions: A multidisciplinary team of experts iteratively created a clinically usable EoE severity scoring system denominated I-SEE'' to guide practitioners in EoE management by standardizing disease components reflecting disease severity beyond eosinophil counts. I-SEE should be validated and refined using data from future clinical trials and routine clinical practice to increase its utilization and functionality.
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