Burden of eosinophilic esophagitis in adult and adolescent patients: results from a real-world analysis

Abstract

Background: Real-world data on the impact of eosinophilic esophagitis (EoE) in patients are limited. This study assessed clinical characteristics, healthcare resource utilization (HCRU), symptoms, comorbidities, and quality of life (QoL) of EoE patients.

Methods: The multicountry cross-sectional survey, Adelphi EoE Disease Specific Programme™, collected physician and patient-reported data on clinical characteristics, HCRU, symptoms, comorbidities, and QOL of EoE patients with past/current proton pump inhibitor use and ongoing dysphagia-related symptoms (September to December 2020) at study entry.

Results: Physicians provided clinical characteristics, symptom, comorbidity, and HCRU data for 412 patients (12-17 years: 8%; ≥18 years: 92%); and 161 of these patients (12-17 years: 6%; ≥18 years: 94%) provided symptom and QOL data. Of the 412 patients, 67% were male, with a mean (SD) age of 37.0 (15.3) years. Overall, 74% of patients were currently being treated with corticosteroids (12-17 years: 88%; ≥18 years: 73%); 25% of patients had a history of esophageal dilations (12-17 years: 19%; ≥18 years: 26%); and 30% of patients had EoE-related emergency room visit (12-17 years: 31%; ≥18 years: 30%) in the last year. Among the 161 patients, heartburn (69%) was the most commonly reported symptom; the greatest negative impacts on QOL were reported for dysphagia-related anxiety, social activities involving food, and maintaining friendships (EoE Impact Questionnaire scores [1-5, low to high impact]: 1.6-2.2 for both age groups).

Conclusion: EoE patients continued to experience disease burden despite receiving treatment, highlighting the high unmet need for effective disease management in this population.

Keywords: clinical burden; eosinophilic esophagitis; healthcare resource utilization; quality of life; real-world evidence.

Fig. 1

Pharmaceutical treatments currently received by patients with EoE aged ≥12 years for treatment of EoE as reported by physicians. Note: Corticosteroids include budesonide, ciclesonide, betamethasone, prednisone, other (unspecified); PPIs include omeprazole, lansoprazole, dexlansoprazole, esomeprazole, other (unspecified); biologics include dupilumab, mepolizumab, reslizumab, omalizumab, other (unspecified); antihistamines include ranitidine, cetirizine, loratadine, other (unspecified). Proportions are not mutually exclusive. At the time this study was conducted no biologic was approved for the treatment of EoE. EoE, eosinophilic esophagitis; PPI, proton pump inhibitor; SCS, systemic corticosteroids; STC, swallowed topical corticosteroids.

Fig. 2

Physician-reported comorbidity burden among patients with EoE aged ≥12 years by patient age. EoE, eosinophilic esophagitis; OAS, oral allergy syndrome; PFS, pollen food allergy syndrome.

Fig. 3

EoE symptom burden other than dysphagia as reported by physicians and patients. ^a,b,c,dMissing responses from patients are excluded. ^bFor 14 patients, the caregiver reported on their behalf. ^cPatients were asked to report the symptoms experienced in the 7 days prior, and physicians were asked to report the symptoms the patients were currently experiencing.

Fig. 4

EoE-IQ impact of EoE symptoms in previous 7 days. ^a,bMissing responses excluded. ^bScore range 1–5, where the score of 1 indicates ‘no impact,’ and 5 indicates ‘extremely high impact.’ EoE, eosinophilic esophagitis; EoE-IQ, EoE Impact Questionnaire.