Efficacy of proton pump inhibitor therapy for eosinophilic oesophagitis in 630 patients: results from the EoE connect registry

Aliment Pharmacol Ther. 2020 Sep;52(5):798-807. doi: 10.1111/apt.15957. Epub 2020 Jul 17.


Background: Proton pump inhibitors (PPIs) are the most commonly used first-line therapy for patients with eosinophilic oesophagitis (EoE). However, many aspects related to PPIs in EoE are still unknown.

Aims: To assess the effectiveness of PPI therapy for EoE in real-world practice.

Methods: This cross-sectional study collected data on PPI efficacy from the multicentre EoE CONNECT database. Clinical remission was defined as a decrease of ≥50% in dysphagia symptom score; histological remission was defined as a peak eosinophil count below 15 eosinophils per high-power field. Factors associated with effectiveness of PPI therapy were identified by binary logistic regression multivariate analyses.

Results: Overall, 630 patients (76 children) received PPI as initial therapy (n = 600) or after failure to respond to other therapies (n = 30). PPI therapy achieved eosinophil density below 15 eosinophils per high-power field in 48.8% and a decreased symptom score in 71.0% of patients. More EoE patients with an inflammatory rather than stricturing phenotype accomplished clinico-histological remission after PPI therapy (OR 3.7; 95% CI, 1.4-9.5); as well as those who prolonged treatment length from 8 to 12 weeks (OR 2.7; 95% CI, 1.3-5.3). After achieving clinico-histological remission of EoE, PPI dosage reduction was effectively maintained in 69.9% of patients, but tended to be less effective among those with a stricturing phenotype.

Conclusions: Inflammatory EoE phenotype and treatment duration up to 12 weeks correlated with greater chance for inducing remission of EoE. A stricturing phenotype decreased response rates to PPI therapy both initially and in the long term.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Databases, Factual
  • Deglutition Disorders / drug therapy
  • Deglutition Disorders / epidemiology
  • Eosinophilic Esophagitis / drug therapy*
  • Eosinophilic Esophagitis / epidemiology
  • Eosinophils / drug effects
  • Eosinophils / pathology
  • Female
  • Humans
  • Leukocyte Count
  • Male
  • Phenotype
  • Proton Pump Inhibitors / therapeutic use*
  • Registries
  • Remission Induction
  • Treatment Outcome


  • Proton Pump Inhibitors