Eosinophilic oesophagitis: relationship of quality of life with clinical, endoscopic and histological activity.
BACKGROUND
Knowledge about determinants of quality of life (QoL) in eosinophilic oesophagitis (EoO) patients helps to identify patients at risk of experiencing poor QoL and to tailor therapeutic interventions accordingly.


OBJECTIVE
To evaluate the impact of symptom severity, endoscopic and histological activity on EoE-specific QoL in adult EoE patients.


METHODS
Ninety-eight adult EoE patients were prospectively included (64% male, median age 39 years). Patients completed two validated instruments to assess EoE-specific QoL (EoO-QoL-A) and symptom severity (adult EoE activity index patient-reported outcome) and then underwent esophagogastroduodenoscopy with biopsy sampling. Physicians reported standardised information on EoE-associated endoscopic and histological alterations. The Spearman's rank correlation coefficient was calculated to determine the relationship between QoL and symptom severity. Linear regression and analysis of variance was used to quantify the extent to which variations in severity of EoE symptoms, endoscopic and histological findings explain variations in QoL.


RESULTS
Quality of life strongly correlated with symptom severity (r = 0.610, P < 0.001). While the variation in severity of symptoms, endoscopic and histological findings alone explained 38%, 35% and 22% of the variability in EoE-related QoL, respectively, these together explained 60% of variation. Symptom severity explained 18-35% of the variation in each of the five QoL subscale scores.


CONCLUSIONS
Eosinophilic oesophagitis symptom severity and biological disease activity determine QoL in adult patients with eosinophilic oesophagitis. Therefore, reduction in both eosinophilic oesophagitis symptoms as well as biological disease activity is essential for improvement of QoL in adult patients. Clinicaltrials.gov number, NCT00939263.
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
E
E
Safroneeva
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
M
M
Coslovsky
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
C E
CE
Kuehni
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
M
M
Zwahlen
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
N A
NA
Haas
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
R
R
Panczak
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
T H
TH
Taft
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
I
I
Hirano
University of North Carolina School of Medicine, Chapel Hill, NC, USA.
E S
ES
Dellon
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
N
N
Gonsalves
Tufts Medical Center, Boston, MA, USA.
J
J
Leung
Viollier AG, Basel, Switzerland.
C
C
Bussmann
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J T
JT
Woosley
Centre Hospitalier Universitaire Vaudois/CHUV, Lausanne, Switzerland.
P
P
Yan
Mayo Clinic, Rochester, MN, USA.
Y
Y
Romero
University of Colorado School of Medicine; Digestive Health Institute, Children's Hospital Colorado, Aurora, CO, USA.
G T
GT
Furuta
Indiana University School of Medicine, Indianapolis, IN, USA.
S K
SK
Gupta
University of California, San Diego, San Diego, CA, USA.
S S
SS
Aceves
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
M
M
Chehade
University Hospital Basel, Basel, Switzerland.|Swiss EoE Research Group, Praxis Römerhof, Olten Switzerland.
A
A
Straumann
Centre Hospitalier Universitaire Vaudois/CHUV, Lausanne, Switzerland.
A M
AM
Schoepfer
D000328:Adult; D000368:Aged; D004724:Endoscopy; D016145:Endoscopy, Digestive System; D057765:Eosinophilic Esophagitis / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult