Eosinophilic gastrointestinal disorders: a narrative review on clinical perspectives and research gaps in the Asian context.

Abstract

Eosinophilic gastrointestinal disorders (EGID) are a heterogeneous group of conditions, comprising eosinophilic esophagitis (EoE) and non-EoE EGID which have gained considerable research interest. There are likely to be differences in disease characteristics between populations with distinct dietary, environmental and cultural backgrounds. However much of our understanding on EGID have come from studies from Europe and North America. The aim of this review is to summarize the recent developments and updates in EGID focusing on disease phenotype specifically in Asian patients, and identify opportunities for future research pertaining to disease profile in the Asian population. Original studies, systematic reviews, meta-analyses and review articles up to March 2024 were systematically searched on PubMed, with specific focus on newer studies published in the past 10 years. Case reports, conference abstracts and articles that were not published in the English language were excluded. Prevalence and incidence of EoE and non-EoE EGID have reportedly increased globally over time, but population-based studies are lacking in Asia. Based on heterogeneous data from a limited number of studies from Asia, there are features in epidemiology, clinical phenotype, and treatment response that may be appreciably distinct in Asian patients with EoE and non-EoE EGID, as compared to the Western patient population. Moreover, the efficacy of novel biologic therapies such as dupilumab in the Asian population has not been well-defined. There is a lack of robust data on many basic aspects of EGID in Asia. There is a pressing need to bridge this gap by building research networks and collaborations across wider regions in Asia, to gather high-quality, multicenter data using standardized and uniform criteria and build a more accurate understanding of EGID in Asian patients.