P1824 - Comparison of Characteristics Between Chinese American and Chinese Patients With Eosinophilic Esophagitis

Ryan Leung, ¹, Mayssan Muftah, MD, MPH², Brent Hiramoto, MD², Wai Keung Leung, MBChB, MD¹, Walter W. Chan, MD, MPH^2
1University of Hong Kong School of Clinical Medicine, Hong Kong, Hong Kong; ²Brigham and Women's Hospital, Boston, MA

Introduction: Eosinophilic esophagitis (EoE) has been rising in incidence over the last few decades and has the highest prevalence in countries with predominantly European ancestry. As it is mostly seen in patients of white race, the clinical and endoscopic characteristics of this subgroup are well understood. There is limited data on the characteristics of Chinese EoE patients, particularly with direct comparison to patients residing in the United States (US). We aimed to characterize and compare these patient subgroups.

Methods: This is a retrospective study of all Chinese patients diagnosed with EoE at a tertiary care center in the US over 3 years and Hong Kong over 10 years. EoE was defined as having 15 or more eos/hpf on esophageal biopsy. Clinical, endoscopic, laboratory, and pathology data were obtained via manual chart review. Descriptive statistics were summarized as means +/- standard deviation for continuous data and frequencies and proportions for binary data. Continuous data were compared using a t-test, and binary data were compared using Fisher’s exact test. Statistical significance was defined as a two-tailed p-value < 0.05.

Results: A total of 18 patients were enrolled in the study, of which 11 were Chinese Americans and 7 were Hong Kong residents. Table 1 compares the characteristics of the two groups. Chinese Americans were younger at diagnosis and less likely to have objective findings of GERD and/or prior anti-reflux procedure. They were also more likely to have endoscopic features of EoE, with a significantly higher rate of presentation with rings compared to patients from Hong Kong. Regarding treatment, all patients in the cohort were prescribed a proton pump inhibitor (PPI) as first-line therapy. We compared the rates of histologic response (< 15 eos/hpf on biopsy). Of the Chinese Americans, 9 had a post-PPI esophagogastroduodenoscopy (EGD), of which 7 (77.78%) achieved histologic remission. Of the Hong Kong residents, 6 had a post-PPI EGD, all of which achieved histologic remission. Overall, the rates of PPI-response of Chinese patients in this cohort are higher than that seen in white patients (42%) at the same US tertiary center.

Discussion: Compared to Chinese patients in Hong Kong, Chinese Americans with EoE are younger, less likely to have GERD, and more likely to have endoscopic features of EoE. While both groups had high rates of PPI response, the lower response rate in Chinese Americans suggests there may be an environmental role in the pathogenesis of EoE.


Disclosures:


Ryan Leung, ¹, Mayssan Muftah, MD, MPH², Brent Hiramoto, MD², Wai Keung Leung, MBChB, MD¹, Walter W. Chan, MD, MPH². P1824 - Comparison of Characteristics Between Chinese American and Chinese Patients With Eosinophilic Esophagitis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.