Active Eosinophilic Esophagitis Associated With Increased Asthma Severity

Active eosinophilic esophagitis (EoE) appears to be associated with lower lung function and increased asthma severity in children with comorbid asthma, according to the results of an analysis presented at the American Academy of Allergy, Asthma & Immunology (AAAAI) Virtual Annual Meeting, held February 26 to March 1, 2021.

While EoE is an important comorbid condition in childhood asthma, the effect of active vs inactive EoE on asthma severity and control has not been studied. Therefore, researchers performed a retrospective chart review on children aged 0 to 18 years evaluated at the Cincinnati Children’s Hospital Medical Center Asthma Center between 2009 and 2015. They collected and analyzed features of EoE, including disease activity defined by greater than 15 eosinophils per high-powered field, and asthma measures, including spirometry, asthma control test (ACT) scores, and severity defined by inhaled corticosteroid dose.

Of the 3071 patients with asthma, 62 (2.0%) also had both endoscopy-proven EoE. Active EoE was associated with lower forced expiratory volume in 1 second (FEV₁; β= -6.15; P =.014) and FEV₁/forced vital capacity (FVC; β=-3.37; P=.0208) compared with children with inactive EoE (adjusted for age, sex, and race). In addition, active EoE was associated with more severe asthma (persistent vs intermittent; β= 1.81; P =.002). However, there were no significant differences in health care use, oral corticosteroid bursts, or ACT scores.

“EoE, when active, is associated with lower lung function and more severe asthma in children,” the study authors wrote. “Prospective cohort studies with larger well-characterized populations are needed to confirm this relationship.”

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