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Generic Measures of Quality of Life Are Not Correlated with Disease Activity in Eosinophilic Esophagitis

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Abstract

Background

The relationship between histologic disease activity in eosinophilic esophagitis (EoE) and generic measures of quality of life (QoL) is unclear.

Aims

To determine differences in QoL in adults with EoE based on histologic activity and assess changes in QoL over time.

Methods

We performed an analysis of prospectively collected data from patients in the University of North Carolina EoE Registry. Patients were categorized with histologically active (≥ 15 eosinophils per high-power field [eos/hpf]) or inactive (< 15 eos/hpf) disease. Dysphagia severity was measured with a Likert scale. QoL was measured with 36-Item Short Form (SF-36), compared between active and inactive groups, and assessed longitudinally.

Results

Of 147 EoE cases, those with inactive disease (n = 56) reported less dysphagia severity (3.2 vs. 1.9; p = 0.003) and had lower endoscopic severity (3.8 vs. 1.0; p < 0.001) than those with active disease (n = 91). While SF-36 scores did not differ between active and inactive status, lower mental component scores (MCS) were seen in patients treated with empiric dietary elimination (44.9 vs. 50.8; p = 0.005). Dysphagia severity was negatively correlated with both physical component score (PCS) (r = −0.33; p < 0.001) and MCS (r = −0.18; p = 0.03). Despite more cases achieving histologic response over time, SF-36 scores did not improve on either raw or adjusted analyses.

Conclusion

QoL measured by SF-36 in EoE was similar regardless of histologic disease activity and was in the range of population averages. General QoL metrics like the SF-36 do not appear to have substantial utility in EoE.

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Funding

This research was supported by NIH awards T35 DK007386 (NC) and R01 DK101856 (ESD).

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Authors and Affiliations

  1. Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, CB#7080, Bioinformatics Building, 130 Mason Farm Rd. UNC-CH, Chapel Hill, NC, 27599-7080, USA

    Nicole Chang, Soha Raja, Nicholas J. Shaheen & Evan S. Dellon

  2. Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Renee Betancourt, Cara Randall, Staci Keene, Amy Lilly, Mark Fowler & John T. Woosley

  3. Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Nicholas J. Shaheen & Evan S. Dellon

Authors
  1. Nicole Chang
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  2. Soha Raja
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  3. Renee Betancourt
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  4. Cara Randall
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  10. Evan S. Dellon
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Contributions

NC, SR, RB, CR, SK, AL, MF, JTW, NJS and ESD approved the final version. NC helped in manuscript drafting, data collection/interpretation, critical revision. SR contributed to data collection, critical revision. RB, CR, SK, AL, MF and JTW helped in data collection/pathology interpretation and critical revision. NJS helped in data interpretation and critical revision. ESD contributed to project conception, supervision, data collection, data analysis/interpretation, manuscript drafting, and critical revision.

Corresponding author

Correspondence to Evan S. Dellon.

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Conflict of interest

Dr. Dellon is a consultant for Abbott, Adare, Aimmune, Allakos, Arena, AstraZeneca, Biorasi, Calypso, Eli Lilly, EsoCap, Gossamer Bio, GSK, Receptos/Celegene, Regeneron, Robarts, Salix, and Shire/Takeda, receives research funding from Adare, Allakos, GSK, Meritage, Miraca, Nutricia, Receptos/Celgene, Regeneron, and Shire/Takeda, and has received an educational Grant from Allakos, Banner, and Holoclara. None of the other authors report any potential conflicts of interest with this study.

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An editorial commenting on this article is available at https://doi.org/10.1007/s10620-020-06780-8.

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Chang, N., Raja, S., Betancourt, R. et al. Generic Measures of Quality of Life Are Not Correlated with Disease Activity in Eosinophilic Esophagitis. Dig Dis Sci 66, 3312–3321 (2021). https://doi.org/10.1007/s10620-020-06719-z

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  • DOI: https://doi.org/10.1007/s10620-020-06719-z

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