The Index of Severity for EoE (I-SEE) was recently developed. We aimed to determine the relationship between features of EoE and disease severity, and assess change in disease severity with topical corticosteroids (tCS) treatment, using I-SEE.
We performed a post-hoc analysis of an 8-week randomized trial comparing two tCS formulations in newly diagnosed EoE patients. I-SEE was calculated at baseline and post-treatment, and patients were classified as mild (1-6 points), moderate (7-14 points), severe (≥15 points), or inactive (0 points). We analyzed clinical, endoscopic, and histologic features at baseline by disease severity, and examined the change in severity before and after treatment, and by histologic response (<15 eos/hpf).
Of 111 subjects randomized, 20 (18%) were classified as mild, 75 (68%) as moderate, and 16 (14%) as severe at baseline. Increasing severity was associated with lower BMI (30 for mild, 27 for moderate, 24 for severe; p=0.01), longer duration of dysphagia symptoms prior to diagnosis (9 years for mild, 9 for moderate, and 20 for severe; p<0.001), and decreasing esophageal diameter (15mm for mild, 13 for moderate, and 10 for severe; p<0.001). Mean severity score decreased after treatment (11 vs 4; p<0.001), with lower scores in histologic responders compared to non-responders (2 vs 9; p<0.001). The severity score at baseline predicted need for dilation at follow-up (C statistic 0.81).
The newly developed I-SEE correlates with many clinical features at diagnosis, and severity improves with successful tCS treatment. Additional investigations in other populations can further confirm its utility.

Copyright © 2023 AGA Institute. Published by Elsevier Inc. All rights reserved.