METHODS: This was a pilot study, including 25 patients with biopsy proven EoE. A pairwise comparison of fresh, powder and extract for milk, egg, soy and wheat was performed on PST wheal size and APT inflammation score by Wilcoxon signed rank test and with Holm step-down Bonferroni method adjustment for multiple hypothesis testing.
RESULTS: Fresh and powder APT were consistently more inflamed than extract. A statistical difference (unadj p<0.05) in the level of inflammation between fresh-extract and powder-extract was observed on APT for all foods. Adjusted p-values demonstrated a difference between fresh and extract APT for milk, soy and wheat (adj p<0.05) indicating that fresh was more likely to show positive score than extract. The comparison between powder and extract was only significant for wheat (adj p=0.02). No differences were observed for PST pairwise comparisons.
CONCLUSIONS: The comparison of PST and APT testing for fresh, powder and extract foods in EoE shows similarity between fresh and powdered foods. Food extracts cause less inflammation than fresh or powder APT. APT with food powders may be a viable option to determine targeted elimination diets, but further testing is required to validate these results.