Daniel J. Green

Cost Utility Analysis of Topical Steroids Compared With Dietary Elimination for Treatment of Eosinophilic Esophagitis

Background & Aims Topical corticosteroids or dietary elimination are recommended as first‐line therapies for eosinophilic esophagitis, but data to directly compare these therapies are scant. We performed a cost utility comparison of topical corticosteroids and the 6‐food elimination diet (SFED) in treatment of eosinophilic esophagitis, from the payer perspective. Methods We used a modified Markov model based on current clinical guidelines, in which transition between states depended on histologic response simulated at the individual cohort‐member level. Simulation parameters were defined by systematic review and meta‐analysis to determine the base‐case estimates and bounds of uncertainty for sensitivity analysis. Meta‐regression models included adjustment for differences in study and cohort characteristics. Results In the base‐case scenario, topical fluticasone was about as effective as SFED but more expensive at a 5‐year time horizon (

The Role of Environmental Exposures in the Etiology of Eosinophilic Esophagitis: A Systematic Review

9261.58 vs

4 Six-Food Elimination Diet or Topical Steroids for First-Line Treatment of Eosinophilic Esophagitis: A Cost-Utility Analysis

5719.72 per person). SFED was more effective and less expensive than topical fluticasone and topical budesonide in the base‐case scenario. Probabilistic sensitivity analysis revealed little uncertainty in relative treatment effectiveness. There was somewhat greater uncertainty in the relative cost of treatments; most simulations found SFED to be less expensive. Conclusions In a cost utility analysis comparing topical corticosteroids and SFED for first‐line treatment of eosinophilic esophagitis, the therapies were similar in effectiveness. SFED was on average less expensive, and more cost effective in most simulations, than topical budesonide and topical fluticasone, from a payer perspective and not accounting for patient‐level costs or quality of life.

Mo1840 Most Patients Demonstrate Correlation Between Symptoms, Endoscopic Findings, and Histology in Response to Topical Steroid Treatment in Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is an emerging clinicopathologic entity defined by abnormal esophageal eosinophilic infiltration. Management of this disease is hampered by limited understanding of etiologic and controllable risk factors. The aim of this systematic review was to determine the environmental risk factors for EoE. We searched the PubMed, Web of Science, and EMBASE databases from January 1, 1950, through June 30, 2015. To identify additional relevant studies, we hand searched bibliographies of included articles. We limited the review to articles using human subjects and consisting of case reports, case series, cross-sectional and cohort studies, and clinical trials. Nineteen articles discuss the risk of environmental exposures on EoE and indicate that environment plays a large role in the etiology of EoE. Seasonal, geographic, and climate-based differences in disease prevalence have been reported, but the exact mediators of this process, possibly aeroallergens that vary over time and from place to place, remain elusive.

Predictors of Response to Steroid Therapy for Eosinophilic Esophagitis and Treatment of Steroid-Refractory Patients

G A A b st ra ct s and 96415 for IFX and code 96413 for VDZ. Results: The NNT and cost per patient with sustained response and remission at 52 weeks for anti-TNF naive UC patients starting induction treatment was estimated to be the lowest for VDZ followed by IFX, GOL, and ADA (Table 1). For the anti-TNF experienced UC patients (Table 2), the NNTs for sustained response and remission for VDZ were lower than those for ADA. For the anti-TNF experienced patients, the cost per patient with a sustained response at 52 weeks was lower for VDZ compared with ADA (

Effects of Race and Sex on Features of Eosinophilic Esophagitis

122,628 [95% CI:

Evaluation of Histologic Cutpoints for Treatment Response in Eosinophilic Esophagitis

67,649;

Mo1832 What Cut-Point Should Be Used to Define a Histologic Response to Topical Steroid Use in Eosinophilic Esophagitis? A Data-Driven Approach Using Symptoms and Endoscopic Findings

300,367];

Assessment of Proximity to Swine Farming Operations as a Risk Factor for Eosinophilic Esophagitis

320,852 [95% CI:

Mo1855 When Eosinophilic Esophagitis Is Refractory to Topical Steroids: Treatment Options and Clinical Outcomes

120,434;