This content is for healthcare professionals only.

This activity is funded by an independent medical education grant from Sanofi and Regeneron Pharmaceuticals and is jointly provided by USF Health and touchIME.

Faculty & Disclosures

Listen on the go
    • Downloads
    Download Slides
    Download Practice Aid
    Download Slides
    Download Slides
    Download Slides
    CORRECT!
    Next question
    Faculty & Disclosures
    Dr Efrem Eren

    Southampton General Hospital, Southampton, UK

    Dr Eren is a clinical immunology consultant and clinical lead for the Department of Immunology at the University Hospital Southampton in the UK. read more

    Through his role as a clinical immunologist, Dr Eren’s experience and expertise covers the assessment and management of patients with both primary and secondary immune deficiency disorders. As an allergist, his experience covers the investigation and management of a broad range of allergic disorders, including eosinophilic oesophagitis, hay fever, food allergy, urticaria and angioedema, and drug allergy.

    Dr Eren also works with the immunology laboratory, giving advice regarding appropriate testing for immunological, allergic and rheumatological diseases and result interpretation.

    Dr Efrem Eren discloses: Advisory board or panel fees from Dr Falk Pharma and Pharming. Speaker bureau fees from Dr Falk Pharma.
    Dr Nirmala Gonsalves

    Northwestern University Feinberg School of Medicine, Chicago, USA

    Dr Nirmala Gonsalves is a professor of medicine in the Division of Gastroenterology & Hepatology at the Northwestern University Feinberg School of Medicine in Chicago, IL, USA. read more

    At Northwestern University, she serves as the co-director of the Northwestern Eosinophilic Gastrointestinal Disorders Program and has authored over 60 publications and presented extensively at international society meetings, invited grand rounds and symposia focusing on eosinophilic gastrointestinal diseases.

    Dr Gonsalves continues to serve as a steering committee member of The International Gastrointestinal Eosinophil Researchers and serves as a site principal investigator for the National Institute of Health funded U54 Grant Consortium of Eosinophilic Gastrointestinal Disease Researchers (PI-Rothenberg) with the mission to develop greater understanding of the pathophysiology of these disorders and improve the lives of patients. Locally, she also serves as the gastrointestinal division director of Faculty Development and Wellness and is a peer coach for the Department of Medicine.

    Dr Nirmala Gonsalves discloses: Advisory board or panel fees from Sanofi Regeneron. Consultancy fees from Allakos, AstraZeneca and Bristol Myers Squibb. Speaker bureau fees from Sanofi Regeneron.
    Dr Jamal Hayat

    St George's University Hospitals NHS Trust, London, UK

    Dr Jamal Hayat is a consultant gastroenterologist and honorary senior lecturer at St George’s University Hospitals, London, UK, having trained at Imperial College School of Medicine, London. read more

    As part of his specialist training, he undertook an MD research degree into the use of advanced diagnostic techniques in upper gastrointestinal disease. His work has been presented at the American Gastroenterology Association, United European Gastroenterology Association and the British Society of Gastroenterology.

    Dr Hayat runs a specialist clinic for patients with oesophageal disorders, including gastro-oesophageal reflux disease and oesophageal motility disorders such as achalasia, Barrett’s oesophagus and eosinophilic oesophagitis. He is a specialist advisor for the National Institute for Health and Care Excellence on gastro-oesophageal reflux disease and was a principal investigator in the UK for the first licensed treatment for eosinophilic oesophagitis. He is a co-author for the British Society of Gastroenterology guidelines on eosinophilic oesophagitis. He currently leads the Gastrointestinal Physiology Unit at St George’s Hospital and is involved in a number of internal and external research trials.

    Dr Jamal Hayat discloses: Advisory board or panel fees from Dr Falk Pharma (relationship terminated). Grant/research support from Medtronic.
    Back to Faculty
    touchIMMUNOLOGY touchIMMUNOLOGY
    SEE ALL VIDEOS
    Start activity
     
    Expert Interviews
    Allergic Conditions, Digestive Disorders CE/CME accredited

    touchEXPERT OPINIONS
    Experts answer questions with in-depth advice on the current clinical landscape and how new therapies and guidance might impact regional clinical practice. Useful tips below will show how to navigate the activity. Close

    Diagnosing and treating patients with EoE: Tackling the difficulties

    Take CE/CME Test

    Dr Eren is a clinical immunology consultant and clinical lead for the Department of Immunology at the University Hospital Southampton in the UK. read more

    Through his role as a clinical immunologist, Dr Eren’s experience and expertise covers the assessment and management of patients with both primary and secondary immune deficiency disorders. As an allergist, his experience covers the investigation and management of a broad range of allergic disorders, including eosinophilic oesophagitis, hay fever, food allergy, urticaria and angioedema, and drug allergy.

    Dr Eren also works with the immunology laboratory, giving advice regarding appropriate testing for immunological, allergic and rheumatological diseases and result interpretation.

    Dr Efrem Eren discloses: Advisory board or panel fees from Dr Falk Pharma and Pharming. Speaker bureau fees from Dr Falk Pharma.

    Take CE/CME Test

    Dr Nirmala Gonsalves is a professor of medicine in the Division of Gastroenterology & Hepatology at the Northwestern University Feinberg School of Medicine in Chicago, IL, USA. read more

    At Northwestern University, she serves as the co-director of the Northwestern Eosinophilic Gastrointestinal Disorders Program and has authored over 60 publications and presented extensively at international society meetings, invited grand rounds and symposia focusing on eosinophilic gastrointestinal diseases.

    Dr Gonsalves continues to serve as a steering committee member of The International Gastrointestinal Eosinophil Researchers and serves as a site principal investigator for the National Institute of Health funded U54 Grant Consortium of Eosinophilic Gastrointestinal Disease Researchers (PI-Rothenberg) with the mission to develop greater understanding of the pathophysiology of these disorders and improve the lives of patients. Locally, she also serves as the gastrointestinal division director of Faculty Development and Wellness and is a peer coach for the Department of Medicine.

    Dr Nirmala Gonsalves discloses: Advisory board or panel fees from Sanofi Regeneron. Consultancy fees from Allakos, AstraZeneca and Bristol Myers Squibb. Speaker bureau fees from Sanofi Regeneron.

    Take CE/CME Test

    Dr Jamal Hayat is a consultant gastroenterologist and honorary senior lecturer at St George’s University Hospitals, London, UK, having trained at Imperial College School of Medicine, London. read more

    As part of his specialist training, he undertook an MD research degree into the use of advanced diagnostic techniques in upper gastrointestinal disease. His work has been presented at the American Gastroenterology Association, United European Gastroenterology Association and the British Society of Gastroenterology.

    Dr Hayat runs a specialist clinic for patients with oesophageal disorders, including gastro-oesophageal reflux disease and oesophageal motility disorders such as achalasia, Barrett’s oesophagus and eosinophilic oesophagitis. He is a specialist advisor for the National Institute for Health and Care Excellence on gastro-oesophageal reflux disease and was a principal investigator in the UK for the first licensed treatment for eosinophilic oesophagitis. He is a co-author for the British Society of Gastroenterology guidelines on eosinophilic oesophagitis. He currently leads the Gastrointestinal Physiology Unit at St George’s Hospital and is involved in a number of internal and external research trials.

    Dr Jamal Hayat discloses: Advisory board or panel fees from Dr Falk Pharma (relationship terminated). Grant/research support from Medtronic.

    Take CE/CME Test
    Useful tips
    • Select in the video player controls bar to choose subtitle language. Subtitles available in English, French, German, Spanish.
    • A practice aid is available for this activity in the Toolkit
    • Downloads including slides are available for this activity in the Toolkit
    Learning Objectives

    After watching this activity, participants should be better able to:

    • Identify key clinical features of EoE in children and adults
    • Explain the diagnostic pathway for EoE and define the usefulness of minimally-invasive tests and tools for diagnosis and monitoring of EoE
    • Summarize the efficacy and safety data for biologics in patients with EoE
    Overview

    Three experts discuss the challenges related to recognizing, diagnosing and treating patients with eosinophilic oesophagitis (EoE) and highlight how advances in diagnostic tools and emerging treatments may impact future care.

    This activity is jointly provided by USF Health and touchIME. read more

    Target Audience

    Allergists, immunologists, gastroenterologists, paediatricians, dietitians, specialty/advanced nurse practitioners, physician assistants and primary health care primary care physicians and nurses involved in the management of EoE.

    Disclosures

    USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity.  The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

    Faculty

    Dr Efrem Eren discloses: Advisory board or panel fees from Dr Falk Pharma and Pharming. Speaker bureau fees from Dr Falk Pharma.

    Dr Nirmala Gonsalves discloses: Advisory board or panel fees from Sanofi Regeneron. Consultancy fees from Allakos, AstraZeneca and Bristol Myers Squibb. Speaker bureau fees from Sanofi Regeneron.

    Dr Jamal Hayat discloses: Advisory board or panel fees from Dr Falk Pharma (relationship terminated). Grant/research support from Medtronic.

    Content reviewer

    Angela M. Hill, Pharm.D., CRPh, has no relevant financial relationships to disclose.

    Touch Medical Contributors

    Kathy Day has no financial interests/relationships or affiliations in relation to this activity.

    USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

    Requirements for Successful Completion

    In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

    If you have questions regarding credit please contact cpdsupport@usf.edu.

    Accreditations

    Physicians

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

    USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu).

    Advanced Practice Providers

    Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

    The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

    Date of original release: 13 February 2024. Date credits expire: 13 February 2025.

    If you have any questions regarding credit please contact cpdsupport@usf.edu.

    This activity is CE/CME accredited

    To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

    Claim Credit
    Useful tips
    • Select in the video player controls bar to choose subtitle language. Subtitles available in English, French, German, Spanish.
    • A practice aid is available for this activity in the Toolkit
    • Downloads including slides are available for this activity in the Toolkit

    You may also be interested in...

    touchFOCUS

    Addressing the diagnosis and management of pet allergies in primary care and beyond

    This activity is CE/CME accredited
    LAUNCH ACTIVITY

    touchEXPERT OPINIONS

    What’s new for eosinophilic oesophagitis? A case-based discussion of patient care

    This activity is CE/CME accredited
    LAUNCH ACTIVITY

    CONFERENCE HUB

    Ana Maria Giménez-Arnau, EAACI 2022: A Phase 2b Study of Remibrutinib for Chronic Spontaneous Urticaria

    GO TO HUB

    CONFERENCE HUB

    Philippe Bégin, AAAAI 2021: Epicutaneous Immunotherapy for Peanut Allergy

    GO TO HUB

    Topics covered in this activity

    Allergic Conditions / Digestive Disorders
    REGISTER NOW FOR FREE ACCESS TO
    • 1000+ topical and insightful peer-reviewed journal articles
    • 100+ hours of bite-sized congress highlights
    • 10 major therapy areas packed with the latest scientific advances
    • 150+ specialties offering learn-on-the-go medical education
    • + Concise email updates and newsletters so you never miss out
    Register For Free Now
    This activity is funded by:

    An independent medical education grant from Sanofi and Regeneron Pharmaceuticals.
    This activity is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 13 February 2024. Date credits expire: 13 February 2025.

    This content is intended for healthcare professionals only. Please confirm that you are a healthcare professional.

    Accept Decline
    Claim Credit
    touchEXPERT OPINIONS
    Diagnosing and treating patients with EoE: Tackling the difficulties
    0.75 CE/CME credit
    Question 1/5
    Which of the following clinical signs is more commonly seen in pre-school aged children with EoE vs adults with EoE?

    EoE, eosinophilic oesophagitis.

    EoE is a disease that can be found in all age groups, and symptoms vary depending on the age of presentation. Clinical manifestations in infants and toddlers generally include vomiting, food refusal, choking with meals and, less commonly, failure to thrive. Predominant symptoms in school-aged children and adolescents include dysphagia, food impaction, and choking/gagging with meals, particularly while eating foods with coarse textures. The predominant symptom in adults is dysphagia; however, intractable heartburn and food avoidance may also be present.

    Abbreviation
    EoE, eosinophilic oesophagitis.

    Reference
    Carr S, et al. Allergy Asthma Clin Immunol. 2018;14:58.

    Question 2/5
    While oesophageal biopsy through upper endoscopy remains the gold standard diagnostic test for EoE, which of the following minimally invasive tools shows the most promise to evaluate oesophageal inflammation in the clinical setting?

    EoE, eosinophilic oesophagitis.

    As upper endoscopy is an invasive and expensive procedure that sometimes requires general anaesthesia in children and conscious sedation in most adult patients, researchers have focused on the development of minimally invasive tools to evaluate oesophagus inflammation. The oesophageal string test, which is currently being validated, uses a specially designed coiled string to collect fluid and proteins from the oesophagus to measure the levels of eosinophil-derived proteins in this fluid. The test has shown good correlation with eosinophilic infiltration in oesophageal biopsy specimens in both children and adults.1
    Endoluminal functional lumen imaging probes should not be used to diagnose EoE, but they may have a role in severity assessment and therapeutic monitoring.2

    Abbreviation
    EoE, eosinophilic oesophagitis.

    References
    1. Barni S, et al. Ital J Pediatr. 2021;47:230.
    2. Hirano I, et al. Clin Gastroenterol Hepatol. 2017;15:325–34.

    Question 3/5
    Your patient with a history of long-term dysphagia and food bolus impaction has undergone endoscopic and histological workup. Which of the following would best confirm a diagnosis of EoE in this patient?

    EoE, eosinophilic oesophagitis; eos, eosinophil; hpf, high-power field.

    The histological diagnosis of EoE is confirmed when 15 or more eosinophils are counted per high-power field in biopsy specimens from proximal/mid oesophagus. The threshold of 15 eosinophils per high-power field has been shown to have a sensitivity of 100% and specificity of 96%, and to reliably distinguish EoE from GORD, which is associated with lower counts of eosinophils and usually involves the distal part of the oesophagus.

    Abbreviation
    EoE, eosinophilic oesophagitis; GORD, gastro-oesophageal reflux disease.

    Reference
    Visaggi P, et al. Therap Adv Gastroenterol. 2021;14:1–17.

    Question 4/5
    Your patient presents with dysphagia and a history of upper GI symptoms. Their upper endoscopy is normal. How would you proceed?

    EoE, eosinophilic oesophagitis; GI, gastrointestinal.

    Guidelines recommend that oesophageal biopsies are taken in all adults with endoscopic signs of EoE, or with symptoms of dysphagia and/or food impaction, even with a normal-appearing oesophagus. It is recommended to take at least six biopsies in total from at least two different anatomical sites within the oesophagus, targeting areas with endoscopic mucosal abnormalities.

    Abbreviation
    EoE, eosinophilic oesophagitis.

    Reference
    Sorge A, et al. Curr Treat Options Gastroenterol. 2023;21:256–71.

    Question 5/5
    In the LIBERTY EoE TREET phase III clinical trial, which frequency of dupilumab 300 mg was associated with the best outcomes?

    EoE, eosinophilic oesophagitis

    The long-term efficacy and safety findings of the LIBERTY EoE TREET clinical trial (NCT03633617) support the use of weekly dupilumab for full control of eosinophilic oesophagitis, since dosing every 2 weeks was ineffective at improving dysphagia even after this relatively prolonged drug exposure.

    Abbreviation
    EoE, eosinophilic oesophagitis.

    Reference
    Rothenberg ME, et al. Lancet Gastroenterol Hepatol. 2023;8:990–1004.

    Back to Activity

    You may also be interested in...

    touchEXPERT OPINIONS

    Diagnosing and treating patients with EoE: Tackling the difficulties

    This activity is CE/CME accredited
    LAUNCH ACTIVITY

    CONFERENCE HUB

    Reinier van Linschoten, UEG Week 2022: Findings from the LADI clinical trial – investigating adalimumab dosing intervals in Crohn’s disease

    GO TO HUB

    touchPANEL DISCUSSION

    Unravelling endotypes for treatment selection in severe type 2 asthma

    This activity is CE/CME accredited
    LAUNCH ACTIVITY

    CONFERENCE HUB

    Stephen B. Hanauer, CCC 2021: Emerging IBD Therapies

    GO TO HUB
    This activity is funded by:

    An independent medical education grant from Sanofi and Regeneron Pharmaceuticals.
    This activity is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 13 February 2024. Date credits expire: 13 February 2025.

    Copied to clipboard!
    accredited arrow-down-editablearrow-downarrow_leftarrow-right-bluearrow-right-dark-bluearrow-right-greenarrow-right-greyarrow-right-orangearrow-right-whitearrow-right-bluearrow-up-orangeavatarcalendarchevron-down consultant-pathologist-nurseconsultant-pathologistcrosscrossdownloademailexclaimationfeedbackfiltergraph-arrowinterviewslinkmdt_iconmenumore_dots nurse-consultantpadlock patient-advocate-pathologistpatient-consultantpatientperson pharmacist-nurseplay_buttonplay-colour-tmcplay-colourAsset 1podcastprinter scenerysearch share single-doctor social_facebooksocial_googleplussocial_instagramsocial_linkedin_altsocial_linkedin_altsocial_pinterestlogo-twitter-glyph-32social_youtubeshape-star (1)tick-bluetick-orangetick-red tick-whiteticktimetranscriptup-arrowwebinar Sponsored Department Location NEW TMM Corporate Services Icons-07NEW TMM Corporate Services Icons-08NEW TMM Corporate Services Icons-09NEW TMM Corporate Services Icons-10NEW TMM Corporate Services Icons-11NEW TMM Corporate Services Icons-12Salary £ TMM-Corp-Site-Icons-01TMM-Corp-Site-Icons-02TMM-Corp-Site-Icons-03TMM-Corp-Site-Icons-04TMM-Corp-Site-Icons-05TMM-Corp-Site-Icons-06TMM-Corp-Site-Icons-07TMM-Corp-Site-Icons-08TMM-Corp-Site-Icons-09TMM-Corp-Site-Icons-10TMM-Corp-Site-Icons-11TMM-Corp-Site-Icons-12TMM-Corp-Site-Icons-13TMM-Corp-Site-Icons-14TMM-Corp-Site-Icons-15TMM-Corp-Site-Icons-16TMM-Corp-Site-Icons-17TMM-Corp-Site-Icons-18TMM-Corp-Site-Icons-19TMM-Corp-Site-Icons-20TMM-Corp-Site-Icons-21TMM-Corp-Site-Icons-22TMM-Corp-Site-Icons-23TMM-Corp-Site-Icons-24TMM-Corp-Site-Icons-25TMM-Corp-Site-Icons-26TMM-Corp-Site-Icons-27TMM-Corp-Site-Icons-28TMM-Corp-Site-Icons-29TMM-Corp-Site-Icons-30TMM-Corp-Site-Icons-31TMM-Corp-Site-Icons-32TMM-Corp-Site-Icons-33TMM-Corp-Site-Icons-34TMM-Corp-Site-Icons-35TMM-Corp-Site-Icons-36TMM-Corp-Site-Icons-37TMM-Corp-Site-Icons-38TMM-Corp-Site-Icons-39TMM-Corp-Site-Icons-40TMM-Corp-Site-Icons-41TMM-Corp-Site-Icons-42TMM-Corp-Site-Icons-43TMM-Corp-Site-Icons-44TMM-Corp-Site-Icons-45TMM-Corp-Site-Icons-46TMM-Corp-Site-Icons-47TMM-Corp-Site-Icons-48TMM-Corp-Site-Icons-49TMM-Corp-Site-Icons-50TMM-Corp-Site-Icons-51TMM-Corp-Site-Icons-52TMM-Corp-Site-Icons-53TMM-Corp-Site-Icons-54TMM-Corp-Site-Icons-55TMM-Corp-Site-Icons-56TMM-Corp-Site-Icons-57TMM-Corp-Site-Icons-58TMM-Corp-Site-Icons-59TMM-Corp-Site-Icons-60TMM-Corp-Site-Icons-61TMM-Corp-Site-Icons-62TMM-Corp-Site-Icons-63TMM-Corp-Site-Icons-64TMM-Corp-Site-Icons-65TMM-Corp-Site-Icons-66TMM-Corp-Site-Icons-67TMM-Corp-Site-Icons-68TMM-Corp-Site-Icons-69TMM-Corp-Site-Icons-70TMM-Corp-Site-Icons-71TMM-Corp-Site-Icons-72