We thank Dr Hopp for his interesting correspondence (“A new acronym for PPI-REE”?)1 in response to our summary of the new consensus agreement for the diagnosis of eosinophilic esophagitis (EoE).2 One goal of the new guidelines was to simplify the diagnosis and terminology. In addition, the new diagnostic criteria were developed so that patients diagnosed with EoE using the previous consensus guidelines would still be considered to have EoE. However, the proposed abbreviation of EoE-PPI-R (eosinophilic esophagitis-proton pump inhibitor responsive) seems to add extra complexity to the terminology. To extend this, in theory, you could have an acronym for EoE responsive to steroids (EoE-RS) and EoE responsive to diet (EoE-RD), but you want to be more specific; for example, there could be a term for EoE responsive to the 4-food elimination diet and not responsive to low-dose topical steroids (EoE-RFFED-NRLDTS). These abbreviations are useful for manuscripts and articles to save space and decrease the word count but would create confusion for daily diagnosis.
We agree that more studies to understand the mechanisms and clinical implications of differential responses to therapeutics are certainly needed. This is pointed out in the full guidelines: “Going forward, … a clinical trial design must specify and provide the rationale for the subtype of EoE population being included, be it PPI-non-responsive, PPI-responsive, or PPI-naïve. Similar considerations would be needed for other EoE treatments as well. These criteria will also allow new research and clinical trials to be conducted that will move the field forward.”3
Therefore, we believe we need to keep the terminology for EoE simple and currently would not recommend additional abbreviations and keep EoE as just EoE.
Acknowledgments
Funding Sources: International Gastrointestinal Eosinophilic Diseases Researchers (TIGERS), David and Denise Bunning Family, and U54AI117804 (CEGIR), which is part of the Rare Disease Clinical Research Network (RDCRN), an initiative of the Office of Rare Disease Research (ORDR), NCATS, and is funded through a collaboration between NIAID, NIDDK, NCATS and patient advocacy groups including APFED, CURED, and EFC, and NIH K24DK100303 (to Dr Furuta).
Footnotes
Disclosures: Dr Spergel is a consultant for Regeneron, DBV Technology, Kaleo, Grant-DBV Technology, Aimmune Therapeutics, Food Allergy Research Education and receives royalties from UpToDate. Dr Dellon is a consultant for Adare, Allakos, Alivio, Banner, Celgene/Receptos, Enumeral, GSK, Regeneron, and Shire; receives research funding from Adare, Celgene/Receptos, Miraca, Meritage, Nutricia, Regeneron, and Shire; receives educational grants from Banner and Holoclara. Dr Liacouras is a consultant for Shire, Adare, Abbott Nutrition, Receptos, and TEVA. Dr Hirano is a consultant for Adare and Allakos. Dr Molina-Infante receives research funding from and is a consultant for Dr Falk Pharma. Dr Bredenoord has nothing to disclose. Dr Furuta is the founder of EnteroTrack, is a consultant for Shire, and receives royalties from UpToDate.
References
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