首页|A Clinical Severity Index for Eosinophilic Esophagitis: Development, Consensus, and Future Directions

A Clinical Severity Index for Eosinophilic Esophagitis: Development, Consensus, and Future Directions

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  • NSTL
  • Elsevier
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.

Eosinophilic esophagitisseveritycomplicationssymptomsendoscopyhistologyENDOSCOPIC REFERENCE SCOREJOINT TASK-FORCEHISTOLOGIC REMISSIONDISEASE-ACTIVITYMODEST ACCURACYADULT PATIENTSAGA INSTITUTEMANAGEMENTDIAGNOSISVALIDATION

McGowan, Emily C.、Moawad, Fouad J.、Peterson, Kathryn A.、Rothenberg, Marc E.、Straumann, Alex、Furuta, Glenn T.、Aceves, Seema S.、Dellon, Evan S.、Khoury, Paneez、Muir, Amanda B.、Liacouras, Chris A.、Safroneeva, Ekaterina、Atkins, Dan、Collins, Margaret H.、Gonsalves, Nirmala、Falk, Gary W.、Spergel, Jonathan M.、Hirano, Ikuo、Chehade, Mirna、Schoepfer, Alain M.、Menard-Katcher, Calies、Katzka, David A.、Bonis, Peter A.、Bredenoord, Albert J.、Geng, Bob、Jensen, Elizabeth T.、Pesek, Robert D.、Feuerstadt, Paul、Gupta, Sandeep K.、Lucendo, Alfredo J.、Genta, Robert M.、Hiremath, Girish

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Allergy & Clin Immunol,Univ Virginia

Div Gastroenterol,Scripps Clin

Div Gastroenterol,Univ Utah Hlth

Dept Pediat,Cincinnati Childrens Hosp Med Ctr

Univ Hosp Zurich

Digest Hlth Inst,Childrens Hosp Colorado

Rady Childrens Hosp

Ctr Esophageal Dis & Swallowing,Univ N Carolina

Human Eosinophil Sect,NIAID

Perelman Sch Med,Univ Penn

Inst Social & Prevent Med,Univ Bern

Sch Med,Univ Colorado

Coll Med,Univ Cincinnati

Feinberg Sch Med,Northwestern Univ

Childrens Hosp Philadelphia

Mt Sinai Ctr Eosinophil Disorders,Icahn Sch Med Mt Sinai

CHU Vaudois

Mayo Clin

Tufts Med Ctr

Dept Gastroenterol,Amsterdam Univ Med Ctr

Univ Calif San Diego

Epidemiol & Prevent,Wake Forest Sch Med

Div Allergy Immunol,Univ Arkansas Med Sci

Div Gastroenterol,Yale New Haven Med Ctr

Sect Pediat Gastroenterol Hepatol Nutr,Indiana Univ Sch Med

Dept Gastroenterol,Hosp Gen Tomelloso

Baylor Coll Med

Dept Pediat,Monroe Carell Jr Childrens Hosp Vanderbilt

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2022

10.1016/j.jaci.2022.03.015

The Journal of Allergy and Clinical Immunology

The Journal of Allergy and Clinical Immunology

ISSN：0091-6749
年,卷(期)：2022.150(1)
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