SCIT May Augment Treatment for EoE with Comorbid Allergic Rhinitis: New Observations
The largest study of the differential impact of subcutaneous immunotherapy on people with EoE and allergic rhinitis found no worsening of EoE and that it could be "helpful."
Subcutaneous immunotherapy (SCIT) may be a valuable adjunct for specific individuals with eosinophilic esophagitis (EoE) who have comorbid allergic rhinitis, according to researchers from the University of North Carolina (UNC) School of Medicine.
Based on understanding of the well-established relationship between the 2 conditions, Scott Commins, MD, PhD, and Evon Dellon, MD, sought to clarify whether or not SCIT has a role in management of individuals who have both by comparing characteristics and treatment outcomes between persons with EoE and allergic rhinitis being treated with SCIT and those not being treated.
They presented their findings at the 2024 American Academy of Allergy, Asthma, and Immunology (AAAAI) annual meeting, February 23-26, 2024, in Washington, DC.
Commins and Dellon conducted a review of chart data for individuals seen at the UNC Medical Center (UNCMC) in Chapel Hill, NC and Allergy Partners of Chapel Hill. For the subset of individuals with EoE and allergic rhinitis, treated and not treated with SCIT, the researchers collected data on symptom frequency, maximum eosinophil count, esophagogastroduodenoscopy (EGD) data, medications, dietary elimination results, and SCIT content. The final cohort included children and adults of any age.
They identified 936 individuals with EoE and allergic rhinitis on SCIT at Allergy Partners of Chapel Hill and 72 at UNCMC between 2008 and 2023. The most common allergen in the studied SCIT was grass pollens, according to the study abstract.
On average, individuals in the EoE group not on SCIT were diagnosed sooner after symptom onset (7.3 years) than those with EoE receiving SCIT (13.8 years), reported Commins and Dellon. They reported also that atopic disease was more prevalent among those with EoE and allergic rhinitis on SCIT. Topical steroid use, on the other hand, was similar between the groups (42% and 47%) as was histologic response. The research partners noted no adverse effects of SCIT on EoE.
The authors state that previous studies of individuals with EoE and allergic rhinitis receiving SCIT have been underpowered and that the current study is the largest to date. “This current data suggests SCIT could be a helpful adjunct for some EoE patients with allergic rhinitis. Importantly, these data suggest use of SCIT is not associated with worsening of EoE,” they concluded.