Patient-reported symptoms and burden of eosinophilic esophagitis: evidence from real-world clinical practice

BMC Gastroenterol. 2024 Aug 3;24(1):246. doi: 10.1186/s12876-024-03334-4.

Abstract

Background: Eosinophilic esophagitis is a chronic inflammatory disorder of the esophagus. This real-world study used patient and physician surveys to describe the clinical characteristics and disease burden of eosinophilic esophagitis-overall and in a subgroup of patients with dysphagia despite treatment.

Methods: Data analyzed in this study were collected in 2020 from US and EU patients with eosinophilic esophagitis. Eligible patients were aged ≥ 12 years with a diagnosis of eosinophilic esophagitis, had an esophageal count of ≥ 15 eosinophils/high-power field at diagnosis, and were currently prescribed treatment for eosinophilic esophagitis.

Results: Overall, 1001 patients were included, of whom 356 (36%) had dysphagia despite treatment. Demographics and clinical characteristics were similar in both populations. The severity of eosinophilic esophagitis was mild in more patients overall (69%) versus those with dysphagia despite treatment (48%). Patient disease history was similar in both populations, with some exceptions: common patient-reported symptoms were dysphagia (70% and 86%) and heartburn/acid reflux (55% and 49%), and common physician-reported symptoms were dysphagia (75% and 91%) and food impaction (46% and 52%). Treatment history was similar in both populations; overall, the most common treatments were proton pump inhibitors (83%) and topical corticosteroids (51%). Patients reported slightly more days with symptoms, higher impacts on activities of daily living, and slightly higher anxiety or depression in the dysphagia-despite-treatment population versus the overall population.

Conclusions: Eosinophilic esophagitis presents severe symptoms and comorbidities that substantially impact patients' well-being and quality of life. Greater awareness of and novel treatments for eosinophilic esophagitis are needed.

Keywords: Disease burden; Eosinophilic esophagitis; Health-related quality of life; Inflammatory disease; Real-world evidence.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Cost of Illness*
  • Deglutition Disorders* / epidemiology
  • Deglutition Disorders* / etiology
  • Eosinophilic Esophagitis* / complications
  • Eosinophilic Esophagitis* / epidemiology
  • Eosinophilic Esophagitis* / therapy
  • Female
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / epidemiology
  • Heartburn / etiology
  • Humans
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Proton Pump Inhibitors* / therapeutic use
  • Quality of Life
  • Severity of Illness Index
  • Young Adult

Substances

  • Proton Pump Inhibitors
  • Adrenal Cortex Hormones