News — BOSTON (Oct. 24, 2024) – Eosinophilic Esophagitis (EoE), a disorder of the esophagus, is increasingly recognized as a major cause of swallowing difficulties in children and adults. It affects about one in 2,000 people and is part of a spectrum of allergic conditions. A new study being presented at this year’s American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting in Boston investigated the probability of patients with certain atopic (allergic) conditions developing EoE.
“We did a separate analysis of four common allergic conditions – asthma, allergic rhinitis, atopic dermatitis and food allergy – to determine the probability of pediatric patients ages 1-18 years with the conditions also developing EoE,” says pediatric resident, Catherine Haber, MD, lead author of the study and ACAAI member. “For each of these atopic conditions, we compared the likelihood of developing EoE with a control group of patients who did not have these allergic or atopic conditions. We found that each of these conditions was associated with an increased risk of developing EoE. We also found that food allergy had the highest risk of developing EoE among the atopic conditions studied.”
The breakdown for each condition was as follows:
- Asthma – 1,885 patients developed EoE versus 726 in the control group who did not
- Allergic rhinitis – 1,444 patients developed EoE versus 829 in the control group who did not
- Atopic dermatitis – 533 patients developed EoE versus 307 in the control group who did not
- Food allergies – 1,098 patients developed EoE versus 166 in the control group who did not
The cohort and control groups were matched in terms of sex, race, and ethnicity. Additionally, they were matched for the other atopic conditions included in this study: asthma, allergic rhinitis, atopic dermatitis, and food allergy.
Abstract Title: RISK OF DEVELOPING EOSINOPHILIC ESOPHAGITIS WITH PREEXISTING ASTHMA, ALLERGIC RHINITIS, ATOPIC DERMATITIS, OR FOOD ALLERGY (Full abstract below)
Presenter: Catherine Haber, MD
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RISK OF DEVELOPING EOSINOPHILIC ESOPHAGITIS WITH PREEXISTING ASTHMA, ALLERGIC RHINITIS, ATOPIC DERMATITIS, OR FOOD ALLERGY
C. Haber*, T. Al-Shaikhly, P. Jhaveri, Hershey, PA.
Introduction: Eosinophilic esophagitis (EoE) is a chronic antigen-mediated disorder of the esophagus leading to esophageal dysfunction that is frequently seen in atopic patients. We investigated the probability of various atopic conditions developing EoE.
Methods: This retrospective cohort study utilized TriNetX US Collaborative Network to identify pediatric patients ages 1-18 years with a diagnosis of asthma, allergic rhinitis, atopic dermatitis, or food allergies from 2016 to 2018. Separate analyses were run for each diagnosis. The control population consisted of patients without the atopy diagnosis who had any documented ICD-10 diagnosis. The cohorts were matched for age at index, sex, race, ethnicity, and the other atopic conditions. The three-year hazard ratio (HR) of developing EoE relative to the controls was calculated.
Results: For the asthma group, there were 1,885 patients that developed EoE versus 726 in the control group (HR 2.35; 95% CI 2.16 – 2.56; p-value <0.001). For the allergic rhinitis group, there were 1,444 patients that developed EoE versus 829 in the control group (HR 1.45; 95% CI 1.34 - 1.58; p-value <0.001). For atopic dermatitis, there were 533 patients that developed EoE versus 307 patients in the control group (HR 1.53; 95% CI 1.33 - 1.76; p-value <0.001). For patients with food allergies, there were 1,098 patients that subsequently developed EoE versus 166 in the control group (HR 6.31; 95% CI 5.36 - 7.43; p-value <0.001).
Conclusion: All atopic risk factors studied were associated with an increased risk of developing EoE. Food allergy had the highest risk of developing EoE.
Summary table demonstrating risk of developing eosinophilic esophagitis among various atopic conditions 
Table demonstrating number at risk of developing eosinophilic esophagitis (EoE) and number that subsequently developed EoE for each atopic condition studied. Hazard ratio for the risk of developing EoE included for each atopic condition with their 95% confidence interval (CI) and P-value.
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