SNSF Grant on quality of care in eosinophilic esophagitis

05.04.2019 - Ekaterina Safroneeva has been awarded a Swiss National Science Foundation grant to develop process-of-care measures and identify long-term treatment targets for adults with eosinophilic esophagitis (EoE). Increasingly recognized though not commonly seen, EoE is a chronic, immune-mediated disease in which untreated inflammation leads to esophageal remodeling with stricture formation and food bolus impactions.

Patients with diseases such as EoE may not always receive optimal quality of care as they pass through the care continuum. In the first part of her project, Ekaterina will work with other international EoE experts to develop quality indicators of process of care that are consistent with clinical practice guidelines. She then will assess the current standard of care among adults with EoE who are enrolled in the Swiss EoE Cohort Study

Although it is important to know when clinical care deviates from indicated, evidence-based care, it is even more important that the care leads to good patient outcomes. Clinicians need to know whether EoE treatment targeting inflammation and symptoms yields better long-term outcomes than symptom-driven treatment alone.

Thus, in the second part of the project Ekaterina will collaborate with the Clinical Trials Unit and gastroenterologists at various Swiss university hospitals to identify appropriate target(s) of treatment that lead to favorable long-term outcomes for EoE patients. In a two-year randomized CONSEIL (CONtrolling Symptoms and Esophageal InfLammation) trial of swallowed topical corticosteroid maintenance treatment in adult EoE patients, outcomes will be compared in two groups: those in whom symptoms alone and those in whom both inflammation and symptoms will be controlled.

If Ekaterina’s hypothesis is correct, targeting both inflammation and symptoms will result in better outcomes, including improved quality of life and fewer strictures and food impactions, than symptom-driven care alone. This study will pave the way for precision medicine approaches to tailor and individualize EoE therapies based upon the best level of evidence possible and much needed definitions of long-term treatment outcomes in EoE.