Alimentary pharmacology & therapeutics
August 27, 2026 · via Europe PMC
Treatment Patterns in Patients With Eosinophilic Oesophagitis Referred for Expert Consultation.
Pomenti SF, Stoffel E, Choy A, Fanuele E, Gonsalves N, Dellon ES, Katzka DA.
AI summary — for doctors, generated from the abstract only
Experts say most EoE patients referred as refractory had received suboptimal medical, dietary or dilation treatment.
What was studied
Anonymous cross-sectional survey of 52 international EoE experts on causes, evaluation and prior therapy of patients referred for refractory EoE.
Key findings
- Experts estimated true refractoriness to medical therapy at 15% and to diet at 31%.
- Referred patients had received PPIs (80%), topical steroids (55%), elimination diets (45%), with dupilumab rarely tried (10%).
- Perceived causes were subtherapeutic dosing (34%), incorrect administration (30.5%), inappropriate drug choice (26.5%) and diet non-adherence (26%).
Clinical relevance
Before referring refractory EoE, optimize drug dose, technique, adherence and consider functional contributors.
Who should care
Limitations
Expert opinion survey with perceived rather than measured data and mostly academic respondents.
Check dosing, administration, adherence and dilation need before labeling EoE refractory.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background & aims
Eosinophilic esophagitis (EoE) patients deemed treatment-refractory are frequently referred to tertiary centres. We aimed to characterize expert perspectives on patients referred for refractory EoE, including its causes, prevalence, and evaluation.
Methods
We conducted an anonymous and blinded cross-sectional survey of international EoE experts (n = 52) assessing provider characteristics, referral patterns, perceived causes of treatment failure, diagnostic approaches, and prior therapies. Descriptive statistics and subgroup analyses were performed.
Results
Respondents were predominantly gastroenterologists (77%) and practiced in academic settings (87%) with high EoE volume. Experts estimated that true refractoriness to medical and diet therapy was 15% [IQR 10-25], median 31% [20-50], respectively. Patients referred for perceived refractory EoE had been treated with PPIs (80%), topical steroids (55%), and elimination diets (45%); dupilumab (10%) was infrequently trialled. Half of the patients referred had been on combination therapy. After referral, experts focused on assessing medication adherence (98%), dosing (92%), and administration technique (90%), with most repeating endoscopy (85%) and performing oesophageal dilation (42%). The causes of perceived refractory disease were subtherapeutic dosing (34%), incorrect medication administration (30.5%), inappropriate medication choice (26.5%), and dietary non-adherence (26%). Functional and behavioural contributors including co-existing oesophageal hypersensitivity (20%), ARFID (9%), and rumination syndrome (5%) were also reported. Experience in treating EoE patients assessed by less than or greater than 10 years did not affect most results.
Conclusions
Among international experts, most referred EoE patients labelled as refractory had received suboptimal medical and dilation therapy. This highlights opportunities to optimize care along guideline recommendations prior to referral.
DOI
10.1111/apt.70951
PMID
42661236
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
Want more like this?
Browse more from the feed. A free account unlocks the full feed, saving and communities.
Back to the research feed