Introduction

The advent of new therapeutic agents might change the management of acute severe ulcerative colitis (ASUC) by reducing the risk of colectomy and thereby changing the natural history of the disease. Thus, the effectiveness and safety of sequential treatment should be elucidated in patients admitted for ASUC. The main aim was to evaluate colectomy-free survival in patients with ASUC refractory to intravenous corticosteroids who failed to infliximab (IFX) or ciclosporin (CyA) and received a second-line (2L) therapy. The secondary aims were to evaluate the short- and long-term effectiveness and to assess the safety of this strategy.

Aims & Methods

Multicentre study of patients admitted with ASUC refractory to corticosteroids who received a 2L therapy after failing either CyA or IFX during the same hospitalisation. Clinical activity was classified based on partial Mayo score and Lichtiger activity index. Patients who stopped the 2L therapy due to disease activity or adverse events were considered failures. Patients were followed-up until colectomy or one year after 2L initiation. Predictors of short-term colectomy-free survival were assessed by logistic regression analysis, while long-term was evaluated by Kaplan-Meier curves and Cox regression models.

Results

A total of 78 patients from 24 European centres were included. As first-line therapy (after failing corticosteroids), IFX was administered to 32 patients, and CyA to 46. The median age at hospital admission was 35 years (IQR 26-47), and 42 (54%) were men. The prescribed therapy after IFX failure was: CyA in 17, tofacitinib in 13, and ustekinumab (UST) in two patients. After CyA failure, IFX was prescribed in 45 patients, and UST in one. At last study visit, 26 patients (33%) were still under the 2L therapy (IFX in 15, CyA in two, tofacitinib in two, and UST in one).

A total of 29 patients (37%) underwent colectomy during the follow-up; the majority of them (93%) within the first eight weeks. Median time to colectomy after starting the 2L therapy was 14 days (IQR 3-23). The main indication of colectomy was primary non-response in 23 patient (79%). In multivariate analysis, older age at hospital admission (OR 1.1, 95%CI 1.0-1.1), the use of CyA as rescue therapy (OR 8.0, 95%CI 1.3-48), and severe disease (vs. moderate) before the rescue therapy initiation (OR 8.7, 95%CI: 2.0-38) were associated with the likelihood of colectomy.
A total of 31 patients (44%) at week 12 and 18 (30%) at week 52 achieved clinical remission under the 2L therapy; 39 patients (55%) at week 12 and 20 patients (33%) at week 52 reached clinical response (including remission). Corticosteroid-free clinical remission was maintained in 26% and 19% of patients at week 12 and at week 52, respectively. Clinical relapse was observed in 43 patients (55%); of them, six patients (14%) intensified the therapy and five (83%) regained response.
25 patients (32%) had adverse events (AE); 14 had serious AE. Resolution with no sequelae was observed in 20 patients (80%). Infections were the most frequent AE, reported in 12 patients (15%), followed by infusion reactions in five (6%). No differences in AEs between the 2L therapies prescribed were observed. There were two deaths: one due to cerebral thrombophlebitis and another due to bacteriemia after colectomy, both when CyA was the therapy prescribed.

Conclusion

A 2L salvage therapy avoids colectomy in a considerable percentage of patients admitted by ASUC and therefore it can be considered after IFX or CyA failure. The individual therapeutic approach must be discussed with patients due to the risk of serious AE

Disclosure

M.J. García has received financial support for travelling and educational activities from Janssen, Pfizer, AbbVie, Takeda, Kern Pharma, Faes Farma and Ferring.
S.Riestra has served as speaker, consultant, and advisory member for or has received research funding from MSD, AbbVie, Takeda, Janssen, Pfizer, Mylan, Biogen, Kern Pharma, Ferring and Faes Farma.
A. Amiot has received consulting fees from Abbvie, Tillotts pharma, Janssen, Hospira, Takeda, Fresenius Kabi, Pfizer and Gilead as well as lecture fees and travel accommodations from Abbvie, Janssen, Biocodex, Hospira, Ferring, Biogen, Tillotts pharma, Fresenius Kabi, Takeda and MSD.
M. Julsgaard has received research grants for other investigator-driven studies from Takeda, has received consultation fee from Ferring and Takeda, and has received speaker's fees from MSD, Ferring, and Takeda.
M. Calafat has served as a speaker or has received educational or advisory fees from Takeda, Janssen, Faes Farma, Ferring, Galapagos, Gilead and MSD.
M.J. Casanova has received education funding from Pfizer, Takeda, Janssen, MSD, Ferring and Abbvie.
E.Savarino has served as speaker for AbbVie, AGPharma, Alfasigma, EG Stada Group, Fresenius Kabi, Grifols, Janssen, Innovamedica, Malesci, Medtronic, Novartis, Pfizer, Reckitt Benckiser, Sandoz, SILA, Sofar, Takeda and Unifarco; has served as consultant for Alfasigma, Amgen, Biogen, Bristol-Myers Squibb, Celltrion, Diadema Farmaceutici, Falk, Fresenius Kabi, Janssen, Merck & Co., Reckitt Benckiser, Regeneron, Sanofi, Shire, SILA, Sofar, Synformulas GmbH, Takeda and Unifarco; and has received research support from Reckitt Benckiser, SILA, Sofar and Unifarco. "Grants or contracts from any entity AbbVie, Janssen, Kern, Takeda, Galapagos, Pfizer Consulting fees: Janssen. Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events, AbbVie, Janssen, Takeda, Pfizer. Support for attending meetings and/or travelFerring, Janssen. Educational activities research projects scientific meetings or advisory boards sponsored by MSD, Ferring, Abbvie.
T. Raine has received research/educational grants and/or speaker/consultation fees from Abbvie, Arena, Aslan, AstraZeneca, Boehringer-Ingelheim, BMS, Celgene, Ferring, Galapagos, Gilead, GSK, Heptares, LabGenius, Janssen, Mylan, MSD, Novartis, Pfizer, Sandoz, Takeda and UCB and has received speaker's fees from Tillots.
J. P. Gisbert has served as a speaker, a consultant and advisory member for or has received research funding from MSD, AbbVie, Pfizer, Kern Pharma, Biogen, Mylan, Takeda, Janssen, Roche, Sandoz, Celgene, Gilead, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Tillotts Pharma, Chiesi, Casen Fleet, Gebro Pharma, Otsuka Pharmaceutical, and Vifor Pharma.
M. Chaparro has served as a speaker, as consultant or has received research or education funding from MSD, AbbVie, Hospira, Pfizer, Takeda, Janssen, Ferring, Shire Pharmaceuticals, Dr. Falk Pharma, Tillotts Pharma, Biogen, Gilead and Lilly.

Introduction

Short-septum Zenker’s diverticulum (ZD) is considered difficult-to-treat because the limited anatomical space which restricts the operating area. Recently, peroral endoscopic septotomy (POES) emerged as a novel third-space technique for addressing this condition.

Aims & Methods

This study aims to compare the effectiveness and safety of POES with traditional flexible endoscopic septotomy (FES) for the treatment of symptomatic patients with short-septum ZD (<25 mm). In this single-center, prospective study we included all consecutive patients referred to Humanitas Research Hospital with symptomatic short-septum ZD who were scheduled to undergo either FES or POES. The primary outcome was the rate of technical success and adverse events (AEs). The secondary outcome was the rate of clinical success at 12 months and recurrence requiring a retreatment. A sensitivity analysis was conducted using propensity score matching. Hazard Ratio (HR) and its associated 95%CI were used for a time-dependent analysis of recurrence.

Results

A total of 94 patients (63.8% male; mean age 72.7 + 10.7 years) underwent endoscopic treatment for a short-septum ZD (mean size 17.0 + 4.3 mm) were included. Among them, 41.5% (n=39) were treated with FES and 58.5% (n=55) with POES (p=n.s.). Overall, the mean procedural duration was 25.3 + 15.7 min, while the mean hospital stay was 0.3 days. Septotomies were performed under deep sedation in 91.5% of patients (n=86), while in 8.5% of them (n=8) the procedure was performed under general anesthesia. Technical success was achieved in 98.9% of patients (n=93), while AEs occurring in 5.3% of cases (n=5), with no statistical difference between groups (p=n.s.). Clinical success was observed in 91.5% of patients (n=86), while recurrence necessitating retreatment in 14.9% of cases (n=14) with no statistical difference between groups (p=n.s.).

Conclusion

Our findings suggest that POES is an effective and safe technique for the treatment of short-septum ZD, showing comparable outcomes to traditional FES.

References

Repici A, Spadaccini M, Belletrutti PJ, et al. Peroral endoscopic septotomy for short-septum Zenker's diverticulum. Endoscopy. 2020 Jul;52(7):563-568.

Introduction

Branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) are frequently associated with acute (AP) or recurrent pancreatitis (RP), likely due to the mucin-induced obstruction of the main pancreatic duct (MPD). According to the 2024 Kyoto Guidelines, pancreatitis represents an indication for surgical evaluation in IPMN patients. However, pancreatic sphincterotomy (PS) may represent a less invasive alternative for patients who are unfit for surgery or as a bridge to surgery, aiming to reduce the risk of further pancreatitis episodes.

Aims & Methods

This single-center retrospective study aimed to assess the efficacy and safety of PS in patients with BD-IPMN and RP. We included 33 patients who underwent PS between 2016 and 2023, with at least 12 months of follow-up. Patients with other causes of RP or prior pancreatic surgery were excluded. The frequency of pancreatitis episodes before and after PS was compared. Clinical success was defined as complete resolution or ≥50% reduction in pancreatitis episodes. Adverse events, presence of worrisome features (WF), and progression to high-risk stigmata (HRS) were evaluated. Statistical analysis was performed using paired t-test and Fisher’s exact test, with p < 0.05 considered significant.

Results

Among the 33 patients analyzed (39.4% female, 60.6% male, mean age 59 ± 13.9 years) clinical success was achieved in 81.8% of the cases. Specifically, 72.7% of the patients experienced no further AP episodes after PS and 9.1% experienced a reduction in episode frequency, while 18.2% of patients did not respond to treatment. Adverse events occurred in 15% of patients, including: 12% with post-ERCP pancreatitis (all mild) and 3% with intra-procedural bleeding; no perforations were reported. During follow-up WF emerged in 5 patients (15%), while no cases of HRS were identified. Among the 6 non-responders, 3 underwent a second PS, with 2 achieving clinical improvement, and 3 underwent duodenocephalopancreasectomy (DCP), including 1 for a concomitant pancreatic ductal adenocarcinoma (PDAC) unrelated to IPMN progression. Notably, no cases of IPMN degeneration were observed in the series

Conclusion

Pancreatic sphincterotomy appears to be a safe and effective approach for managing recurrent pancreatitis in patients with BD-IPMN, potentially reducing the need for surgery in selected cases.

Introduction

Mirikizumab (miri), a p19-directed IL-23 antibody, has been shown to be effective in patients with moderately-to-severely active ulcerative colitis (UC) in Phase 3 trials (LUCENT-1 NCT03518086; LUCENT-2 NCT03524092).¹ The relationship between symptomatic, endoscopic, and clinical remission and levels of the inflammatory biomarker faecal calprotectin (fCAL) was studied for miri-treated patients enrolled in the trials.

Aims & Methods

This post hoc analysis evaluated patients treated with intravenous (IV) miri 300mg every 4 weeks (Q4W) until week (W)12 in induction (n=868) followed by subcutaneous miri (n=365) Q4W up to W52 (miri induction responders at W12 who were rerandomized for the maintenance period) or placebo. The improvement in fCAL at W12 and W52 between miri and placebo were compared using Cochran Mantel Haenszel, adjusting for randomization stratification factors. Missing data were imputed as nonresponse. The relationship between achieving symptomatic, endoscopic, or clinical remission (defined in Table) and fCAL levels at W4, W12 and W52 was assessed using receiver operating characteristic (ROC) approaches. Predictability was measured by area under the ROC curve (AUC), and AUC≤0.5 indicates no predictability. Optimal fCAL threshold was obtained based on Youden Index.

Results

Greater proportions of miri-treated patients compared to placebo achieved fCAL≤250 ug/g at W4, W12, and W52. A total of 19.0% vs. 12.5%, 34.3% vs. 20.1%, 50.7% vs 19.3% patients achieved fCAL≤250 ug/g at W4, W12, and W52 miri vs. placebo, respectively. Greater proportions of patients achieving symptomatic, endoscopic, and clinical remission reached the predefined threshold of fCAL≤250 ug/g or the optimum fCAL threshold obtained from the ROC (see Table footnote) in this study compared with those not achieving the endpoints (Table). W4 fCAL levels had 70.5% predictability for W12 endoscopic remission and 64.9% for clinical remission, but lower predictability for symptomatic remission (59.1%). W12 fCAL levels had 83.0% predictability for W12 endoscopic remission, 78.5% for clinical remission, and 67.4% for symptomatic remission. W52 fCAL levels had higher predictability for W52 endoscopic (76.6%) and clinical remission (72.7%) than for symptomatic remission (62.3%).

Table. Faecal Calprotectin Normalization at Week 12 in LUCENT-1 and Week 52 in LUCENT-2 per achievement of efficacy outcomes

		Symptomatic Remission		Endoscopic Remission		Clinical Remission
Week 4		Achieving (N=360)	Not Achieving (N=406)	Achieving (N=290)	Not Achieving (N=478)	Achieving (N=193)	Not Achieving (N=571)
	fCAL ≤ 250 ug/g	109 (30.3)	79 (19.5)╪	122 (42.1)	65 (13.6) ╪	77 (39.9)	110 (19.3)╪
	Optimum fCAL threshold	193 (53.6)	159 (39.2)╪	158 (54.5)	106 (22.2)╪	103 (53.4)	168 (29.4)╪
Week 12		Achieving (N=364)	Not Achieving (N=398)	Achieving (N=293)	Not Achieving (N=472)	Achieving (N=199)	Not Achieving (N=562)
	fCAL ≤ 250 ug/g	200 (55.0)	116 (29.2)╪	216 (73.7)	100 (21.2)╪	151 (75.9)	164 (29.2)╪
	Optimum fCAL threshold	237 (65.1)	149 (37.4)╪	216 (73.7)	93 (19.7)╪	151 (75.9)	157 (27.9)╪
Week 52		Achieving (N=230)	Not Achieving (N=44)	Achieving (N=188)	Not Achieving (N=93)	Achieving (N=166)	Not Achieving (N=107)
	fCAL ≤250 ug/g	161 (70.0)	22 (50.0)*	151 (80.3)	38 (40.9)╪	133 (80.1)	49 (45.8)╪
	Optimum fCAL threshold	161 (70.0)	21 (47.7)*	134 (71.3)	24 (25.8)╪	129 (77.7)	42 (39.3)╪

ES=Endoscopic Subscore; fCAL=Faecal Calprotectin; RB = Rectal Bleeding; SF=Stool Frequency.
Data shown as n(%). *p<0.05 and ^╪p<0.001 from Fisher's exact test. Symptomatic remission: SF=0 or 1 with a ≥1-point decrease from baseline, RB=0. Endoscopic remission: ES=0 or 1 (excluding friability). Clinical remission: SF=0 or 1 with a ≥1-point decrease from baseline, RB=0, and ES=0 or 1 (excluding friability). Optimal fCAL for symptomatic/endoscopic/clinical remission: ≤585/≤390/≤415 ug/g at Week 4; ≤365/≤230/≤230 ug/g at Week 12; ≤230/≤150/≤205 ug/g at Week 52.

Conclusion

These results support the use of fCAL as an early predictor of clinical outcomes and as a non-invasive biomarker for predicting clinical outcomes.

References

1. D’Haens G, et al. NEJM 2023;388(26):2444-2455. DOI: 10.1056/NEJMoa2207940

Disclosure

SV has received research support from AbbVie, Johnson & Johnson, Pfizer, Galapagos, and Takeda; lecture fees from AbbVie, Alimentiv, Arena Pharmaceuticals, AstraZeneca, Bristol Myers Squibb, Ferring, Galapagos, Genentech-Roche, Gilead, Janssen, Johnson & Johnson, Lilly, Materia Prima, Merck Sharp & Dohme, Pfizer, Takeda, Tillotts Pharma, and Zealand Pharma; and consulting fees from AbbVie, AbolerIS Pharma, AgomAb, Alimentiv, Arena Pharmaceuticals, AstraZeneca, Avaxia, BMS, Boehringer Ingelheim, Celgene, CVasThera, Dr Falk Pharma, Ferring, Galapagos, Genentech-Roche, Gilead, GSK, Hospira, Imidomics, Janssen, Johnson & Johnson, Lilly, Materia Prima, MiroBio, Morphic, MrMHealth, Mundipharma Merck, Pfizer, Prodigest, Progenity, Prometheus, Robarts Clinical Trials, Second Genome, Shire, Surrozen, Takeda, Theravance, Tillots Pharma, and Zealand Pharma.
ML has served as a Consultant for AbbVie, Pfizer, Takeda, Lilly, Bristol-Meyers Squibb, Target RWE, and Prometheus and has received research support from Pfizer, Takeda, and Janssen.
PD has consulted for Abbvie, Abivax, Adiso, Bristol Myers Squibb, GSK, Janssen, Lilly, Pfizer, and Takeda; grant support from Bristol-Myers Squibb, Janssen, Pfizer, and Takeda; Licensing royalties from PreciDiag.
CM has received consulting fees from AbbVie, Alimentiv, Amgen, AVIR Pharma Inc, Bristol Myers Squibb, Celltrion, Eli Lilly, Ferring, Fresenius Kabi, Janssen, McKesson, Mylan, Pendopharm, Pfizer, Prometheus Biosciences Inc., Roche, Sanofi, Takeda, Tillotts Pharma; speaker's fees from AbbVie, Amgen, AVIR Pharma Inc, Alimentiv, Bristol Myers Squibb, Eli Lilly, Ferring, Fresenius Kabi, Janssen, Organon, Pendopharm, Pfizer, Sanofi, Takeda, Tillotts Pharma; royalties from Springer Publishing; research support from AbbVie, Ferring, Pfizer.
F C-D, RM, and BZ are employees and minor shareholders of Eli Lilly and Company.
JP is an employee of Syneos Health.
ST has served as a paid consultant to AbbVie, Allergan, Amgen, Asahi, Bioclinica, Biogen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, ChemoCentryx, Cosmo, Enterome, Equillium, Ferring, GSK, Genentech, Genzyme, Giuliani SpA, Immunocore, Immunometabolism, Janssen, Lilly, MSD, Merck, Mestag, Neovacs, Novo Nordisk, NPS Pharmaceuticals, Pfizer, Proximagen, Receptos, Roche, Satisfai Health, Sensyne Health, Shire, Sigmoid Pharma, Sorriso, Takeda, Topivert, UCB, VHsquared, Vifor, and Zeria; he has received grants and/or has grants pending from AbbVie, ECCO, Helmsley Trust, IOIBD, Janssen, Lilly, Norman Collisson Foundation, Pfizer, UCB, UKIERI, and Vifor; he has received honoraria from AbbVie, Amgen, Biogen, Ferring, Lilly, Pfizer, and Takeda; and he has had travel/accommodation expenses covered or reimbursed by AbbVie, Amgen, Biogen, Ferring, Lilly, Johnson & Johnson, Pfizer, and Takeda.
RP reports personal fees from Abbott, AbbVie, Alimentiv [formerly Robarts], Amgen, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Celltrion, Cosmos Pharmaceuticals, Eisai, Elan, Lilly, Ferring, Fresenius Kabi, Galapagos, Genentech, Gilead Sciences, GlaxoSmithKline, HC3 Communications, Janssen, Meducom, Merck, Mylan, Oppilan, Organon, Pandion Pharma, Pfizer, Progenity, Protagonist Therapeutics, Receptos, Roche, Sandoz, Satisfai Health, Schering-Plough, Shire, Sublimity Therapeutics, Takeda, Theravance Biopharma, Trellus Health, and UCB.

Introduction

Faecal calprotectin (FC) is of value in differentiating Inflammatory Bowel Disease (IBD) from other causes of lower gastrointestinal (GI) symptoms and is recommended in national guidance. This study aims to examine its role and factors associated with faecal calprotectin requesting in primary care.

Aims & Methods

Retrospective open cohort study using Clinical Practice Research Datalink (CPRD Aurum) of adults aged over 18 years with lower GI symptoms between 2015 and 2019. FC requested 30 days before to 3 months after a lower GI symptom record in primary care were included. Logistic regression analysis explored patient level factors associated with FC testing. Referral pathways and outcomes (IBD diagnoses) of patients with and without FC testing were also examined.

Results

Of 741,190 symptomatic patients, only 18,320 (2.5%) had FC requested in primary care: median age 38.3 (IQR 28.9-50.7); 51.4% female. The rate of FC requesting in symptomatic patients increased from 0.02% in 2010 to 4.4% in 2019 (p=0.001).
FC value of <50 ug/g and 50-200 ug/g were predominantly seen in patients with abdominal pain (42.1% and 37.9% respectively), while FC > 200 ug/g was predominantly seen in patients with diarrhoea (45.3%). Factors associated with FC requesting included: increasing age (>70 years adjusted Odds Ratio 0.16 (95% CI 0.15-0.18)); female (0.89 (0.86-0.92); Black (0.61(0.56-0.66) or Asian (0.75 (0.70-0.80) ethnicity; obesity (0.89(0.85-0.93); lower socioeconomic status (0.91(0.86-0.98); comorbidity score >2 (0.73(0.68-0.79); current smoking (0.89(0.85-0.92)); change in bowel habit (7.31(6.90-7.75), rectal bleeding (2.04(1.95-2.13) or diarrhoea (2.88(2.78-2.99) compared to abdominal pain; and ex-smokers (1.06(1.03-1.11).
IBD was diagnosed in 21.5% of patients referred with a FC >200 ug/g, but only 2.9% of referred patients with a FC 50-200 ug/g. The only patients with a significant risk of IBD with FC 50-200ug/g were patients with rectal bleeding (8%), with the risk in all other patients only 1.7%. 27.8% patients with a normal FC test result were still referred to secondary care, of which only 0.4% had IBD.

Conclusion

Despite an increase in FC requests in recent years, only 4.4% of patients with relevant lower GI symptoms had an FC requested in primary care as recommended. Despite a negative FC test, a third of patients were still referred to secondary care, with very few diagnosed with IBD . Patients with an FC between 50 ug/g and 200 ug/g without rectal bleeding have a low risk of IBD and can be safety netted in primary care.

Introduction

The Swiss Eosinophilic Esophagitis Cohort Study (SEECS) is a national prospective cohort for adults with eosinophilic esophagitis (EoE) that was established in 2015 with the aim of improving quality of care considering EoE’s increased incidence. The SEECS allows for documentation of EoE’s natural history, patients’ quality of life (QoL) and monitoring of treatment efficacy and safety. It also aims to promote clinical and translational research projects with the availability of standard operating procedures (SOPs) for the submission of scientific protocols. The first cohort update was published in 2017. Between 2020 and 2022, paper questionnaires were gradually replaced by fully electronic data capture using Research Electronic Data Capture (REDCap) software. We aim to provide a second update of the cohort, eight years after its launch.

Aims & Methods

The SEECS includes adult patients (age ≥18 years) with EoE, gastro-esophageal reflux (GERD) and healthy controls (HC) using strict eligibility criteria in line with the most recent guidelines. Upon inclusion and follow-up (typically once a year), patients and physicians complete questionnaires in REDCap which are available in German, French, and English. Patients reported outcomes (PROs) and biologic activity are assessed all on the same day using validated instruments (EEsAI PRO for symptoms; EoE-QoL-A for QoL; EREFS for endoscopic activity; modified EoE-HSS for histologic activity). The SEECS biobank includes biosamples (blood samples, esophageal biopsies) from patients with EoE, GERD, and HC.

Results

As of July 2023, the SEECS includes 778 patients [716 (92%) with EoE, 29 (3.8%) with GERD, and 33 (4.2%) HC; 559/778 (71.9%) are male]. Mean age±SD (years) according to diagnosis is as follows: EoE 41.9±12.9, GERD 53.6±16.4, HC 51.7±17.2. Mean diagnostic delay for the EoE group is 89.6±96.2 months. Concomitant GERD is found in 200 patients (27.9%) of the EoE cohort. Concomitant allergic disorders (asthma, rhinoconjunctivitis, neurodermitis) are present in 500 patients (74.4%) with EoE. At inclusion, 694 (96.9%) of EoE patients have an ongoing treatment [orodispersible budesonide tablet: 290 patients (41.8%); budesonide/fluticasone syrup: 281 patients (40.5%); PPI: 162 patients (23.3%); elimination diets: 103 patients (14.8%); esophageal dilation at last visit: 166 patients (23.9%)]. Esophageal biopsies are available from 525/778 (67.5%) patients including 468 EoE patients (65.4%).

Conclusion

Our findings are in line with the available literature on EoE’s natural history. To our knowledge, the SEECS is the only national cohort for EoE adult patients that includes both GERD and healthy controls with their biosamples. Data capture is based on validated instruments and is fully electronic using REDCap. The SEECS offers up-to-date epidemiologic data on EoE and promotes research projects.

Disclosure

Jeanine Wakim has no relevant financial, professional, or personal relationships to disclose. Ekaterina Safroneeva reports (i) consulting fees from Avir Pharma, Inc., Aptalis Pharma, Inc., Celgene Corp., Novartis, AG, and Regeneron Pharmaceuticals Inc; (ii) being an employee of Tillotts Pharma AG. Catherine Saner has no relevant financial, professional, or personal relationships to disclose. Jean-Benoit Rossel has no relevant financial, professional, or personal relationships to disclose. Sven Trelle has no relevant financial, professional, or personal relationships to disclose. Marcel Zwahlen has no relevant financial, professional, or personal relationships to disclose. Luc Biedermann received consulting fees and/or speaker fees and/or research grants from Adare/Ellodi Pharmaceuticals, Inc., AstraZeneca, AG, Switzerland, Receptos-Celgene-BMS, Dr. Falk Pharma, GmbH, Germany, Glaxo Smith Kline, AG, Nestlé S. A., Switzerland, Novartis, AG, Switzerland, and Regeneron-Sanofi Pharmaceuticals. Andrea Kreienbuehl has no relevant financial, professional, or personal relationships to disclose. Thomas Greuter received consulting fees and/or speaker fees and/or research grants from Adare/Ellodi Pharmaceuticals, Inc., AstraZeneca, AG, Switzerland, Receptos-Celgene-BMS, Dr. Falk Pharma, GmbH, Germany, Glaxo Smith Kline, AG, Nestlé S. A., Switzerland, Novartis, AG, Switzerland, and Regeneron-Sanofi Pharmaceuticals. Philipp Schreiner received consulting fees and/or speaker fees from Dr. Falk Pharma, GmbH, Takeda, Regerenon-Sanofi Pharmaceuticals, Abbvie, Janssen-Cilag, Receptos-Celgene-BMS. Peter Netzer has no relevant financial, professional, or personal relationships to disclose. Annett Franke has no relevant financial, professional, or personal relationships to disclose. Stephan Brand has no relevant financial, professional, or personal relationships to disclose. Chantal Hasler has no relevant financial, professional, or personal relationships to disclose. Patrick Aepli has no relevant financial, professional, or personal relationships to disclose. Emanuel Burri has no relevant financial, professional, or personal relationships to disclose. Achim Weber has no relevant financial, professional, or personal relationships to disclose. Christine Sempoux has no relevant financial, professional, or personal relationships to disclose. Ruggero Biral has no relevant financial, professional, or personal relationships to disclose. Wolfram Jochum has no relevant financial, professional, or personal relationships to disclose. Joachim Diebold has no relevant financial, professional, or personal relationships to disclose. Niels Willi has no relevant financial, professional, or personal relationships to disclose. Alex Straumann received consulting fees and/or speaker fees and/or research grants from Adare/Ellodi Pharmaceuticals, Inc., AstraZeneca, AG, Switzerland, Receptos-Celgene-BMS, Dr. Falk Pharma, GmbH, Germany, Glaxo Smith Kline, AG, Nestlé S. A., Switzerland, Novartis, AG, Switzerland, and Regeneron-Sanofi Pharmaceuticals. Alain Schoepfer received consulting fees and/or speaker fees and/or research grants from Adare/Ellodi Pharmaceuticals, Inc., AstraZeneca, AG, Switzerland, Receptos-Celgene-BMS, Dr. Falk Pharma, GmbH, Germany, Glaxo Smith Kline, AG, Nestlé S. A., Switzerland, Novartis, AG, Switzerland, and Regeneron-Sanofi Pharmaceuticals.