The following is a summary of “Clinical Features and Treatment Response to Topical Steroids in Ethnic and Racial Minority Patients With Eosinophilic Esophagitis,” published in the February 2024 issue of Gastroenterology by Ocampo, et al.

Disparities in the presentation and outcomes of eosinophilic esophagitis (EoE) among different ethnic and racial groups have not been extensively studied. For a study, researchers sought to investigate potential differences in the presentation at diagnosis and response to topical corticosteroid (tCS) treatment between EoE patients of Hispanic/Latinx ethnicity or non-White race compared to their counterparts.

A retrospective cohort study involved individuals of any age with a new EoE diagnosis and documented ethnicity or race. Among those receiving tCS treatment and undergoing follow-up endoscopy/biopsy, histologic response (<15 eosinophils/hpf), global symptom response, and endoscopic response were evaluated. Comparisons were made between Hispanic and non-Hispanic EoE patients, as well as between White and non-White patients, at baseline and pre-and post-treatment.

Among 1,026 EoE patients with available ethnicity data, only 23 (2%) were Hispanic. Most clinical characteristics at presentation were similar between Hispanic and non-Hispanic EoE patients, but the histologic response to tCS appeared numerically lower among Hispanics (38% vs. 57%). Non-White EoE patients (13%) were diagnosed at a younger age. They had lower insurance coverage, lower zip code-level income, shorter symptom duration, more vomiting, less dysphagia and food impaction, fewer typical endoscopic features, and less dilation. Among 475 patients with race data undergoing tCS treatment, non-White individuals exhibited a significantly lower histologic response rate compared to Whites (41% vs. 59%; P = 0.01), with the odds of histologic response remaining lower even after adjusting for potential confounders (adjusted odds ratio 0.40, 95% CI: 0.19–0.87).

The study found a small proportion of Hispanic EoE patients with similar clinical presentations as non-Hispanics, while the non-White EoE group comprised a larger proportion, presenting with less dysphagia-specific symptoms. Moreover, non-White patients were notably less likely to respond to tCS treatment compared to their White counterparts.

Reference: journals.lww.com/ajg/abstract/2024/02000/clinical_features_and_treatment_response_to.15.aspx