Patient-reported symptoms and burden of eosinophilic esophagitis: evidence from real-world clinical practice.
Humans
Eosinophilic Esophagitis
/ epidemiology
Male
Female
Deglutition Disorders
/ etiology
Middle Aged
Proton Pump Inhibitors
/ therapeutic use
Adult
Patient Reported Outcome Measures
Cost of Illness
Severity of Illness Index
Quality of Life
Heartburn
/ etiology
Adrenal Cortex Hormones
/ therapeutic use
Gastroesophageal Reflux
/ complications
Aged
Adolescent
Young Adult
Disease burden
Eosinophilic esophagitis
Health-related quality of life
Inflammatory disease
Real-world evidence
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
03 Aug 2024
03 Aug 2024
Historique:
received:
25
10
2023
accepted:
22
07
2024
medline:
4
8
2024
pubmed:
4
8
2024
entrez:
3
8
2024
Statut:
epublish
Résumé
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. 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. 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. 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.
Sections du résumé
BACKGROUND
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
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
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
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.
Identifiants
pubmed: 39097693
doi: 10.1186/s12876-024-03334-4
pii: 10.1186/s12876-024-03334-4
doi:
Substances chimiques
Proton Pump Inhibitors
0
Adrenal Cortex Hormones
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
246Informations de copyright
© 2024. The Author(s).
Références
Dellon ES, Gonsalves N, Hirano I, et al. ACG clinical guideline: evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE). Am J Gastroenterol. 2013;108(5):679–92.
doi: 10.1038/ajg.2013.71
pubmed: 23567357
Lucendo AJ, Molina-Infante J, Arias A, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United Eur Gastroenterol J. 2017;5(3):335–58.
doi: 10.1177/2050640616689525
Pokrzywinski RM, Harding G, Brooks A, Goodwin B, Williams J. Documenting the journey of patients with eosinophilic esophagitis and the impact of the disease on patients and their caregivers: a cross-sectional, qualitative research study. Adv Ther. 2020;37(10):4458–78.
doi: 10.1007/s12325-020-01463-2
pubmed: 32880822
Jensen ET, Kappelman MD, Martin CF, Dellon ES. Health-Care utilization, costs, and the burden of disease related to eosinophilic esophagitis in the United States. Am J Gastroenterol. 2015;110(5):626–32.
doi: 10.1038/ajg.2014.316
pubmed: 25267327
Bredenoord AJ, Patel K, Schoepfer AM, et al. Disease Burden and Unmet need in Eosinophilic Esophagitis. Am J Gastroenterol. 2022;117(8):1231–41.
doi: 10.14309/ajg.0000000000001777
pubmed: 35417421
O’Shea KM, Aceves SS, Dellon ES, et al. Pathophysiology of Eosinophilic Esophagitis. Gastroenterology. 2018;154(2):333–45.
doi: 10.1053/j.gastro.2017.06.065
pubmed: 28757265
Jorveza. (budesonide) [package insert]. Freiburg, Germany: Dr. Falk Pharma GmbH; 2022.
Jorveza. (budesonide) [package insert]. Blainville, Quebec, Canada: AVIR Pharma Inc.; 2022.
Dellon ES, Liacouras CA, Molina-Infante J, et al. Updated International Consensus Diagnostic Criteria for Eosinophilic Esophagitis: Proceedings of the AGREE Conference. Gastroenterology. 2018;155(4):1022–1033.e10.
Greuter T, Hirano I, Dellon ES. Emerging therapies for eosinophilic esophagitis. J Allergy Clin Immunol. 2020;145(1):38–45.
doi: 10.1016/j.jaci.2019.10.027
pubmed: 31705907
Lucendo AJ, Arias-Gonzalez L, Molina-Infante J, Arias A. Systematic review: health-related quality of life in children and adults with eosinophilic oesophagitis-instruments for measurement and determinant factors. Aliment Pharmacol Ther. 2017;46(4):401–9.
doi: 10.1111/apt.14194
pubmed: 28639700
Taft TH, Carlson DA, Simons M, et al. Esophageal hypervigilance and symptom-specific anxiety in patients with eosinophilic esophagitis. Gastroenterology. 2021;161(4):1133–44.
doi: 10.1053/j.gastro.2021.06.023
pubmed: 34153298
FDA Approves First Treatment for Eosinophilic Esophagitis, a Chronic Immune Disorder. 2022; https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-eosinophilic-esophagitis-chronic-immune-disorder
Mukkada V, Falk GW, Eichinger CS, King D, Todorova L, Shaheen NJ. Health-related quality of life and costs Associated with Eosinophilic Esophagitis: a systematic review. Clin Gastroenterol Hepatol. 2018;16(4):495–503.e8.
doi: 10.1016/j.cgh.2017.06.036
pubmed: 28655543
Franciosi JP, Hommel KA, DeBrosse CW, et al. Quality of life in paediatric eosinophilic oesophagitis: what is important to patients? Child Care Health Dev. 2012;38(4):477–83.
doi: 10.1111/j.1365-2214.2011.01265.x
pubmed: 21671982
Taft TH, Kern E, Keefer L, Burstein D, Hirano I. Qualitative assessment of patient-reported outcomes in adults with eosinophilic esophagitis. J Clin Gastroenterol. 2011;45(9):769–74.
doi: 10.1097/MCG.0b013e3182166a5a
pubmed: 21552137
Flood EM, Beusterien KM, Amonkar MM, et al. Patient and caregiver perspective on pediatric eosinophilic esophagitis and newly developed symptom questionnaires*. Curr Med Res Opin. 2008;24(12):3369–81.
doi: 10.1185/03007990802536900
pubmed: 19032119
Thanawala SU, Beveridge CA, Muir AB et al. Hashing out current social media use in eosinophilic esophagitis. Dis Esophagus 2021;34(11):doab059.
Chang JW, Chen VL, Rubenstein JH, Dellon ES, Wallner LP, De Vries R. What patients with eosinophilic esophagitis may not share with their providers: a qualitative assessment of online health communities. Dis Esophagus 2022;35(6):doab073.
Anderson P, Benford M, Harris N, Karavali M, Piercy J. Real-world physician and patient behaviour across countries: Disease-Specific programmes - a means to understand. Curr Med Res Opin. 2008;24(11):3063–72.
doi: 10.1185/03007990802457040
pubmed: 18826746
Kelley ML Jr., Frazer JP. Symptomatic mid-esophageal webs. JAMA. 1966;197(2):143–6.
doi: 10.1001/jama.1966.03110020131047
pubmed: 5952499
Shiflett DW, Gilliam JH, Wu WC, Austin WE, Ott DJ. Multiple esophageal webs. Gastroenterology. 1979;77(3):556–9.
doi: 10.1016/0016-5085(79)90022-2
pubmed: 456849
Landres RT, Kuster GG, Strum WB. Eosinophilic esophagitis in a patient with vigorous achalasia. Gastroenterology. 1978;74(6):1298–301.
doi: 10.1016/0016-5085(78)90710-2
pubmed: 648822
Taft TH, Guadagnoli L, Edlynn E. Anxiety and depression in Eosinophilic Esophagitis: a scoping review and recommendations for Future Research. J Asthma Allergy. 2019;12:389–99.
doi: 10.2147/JAA.S193045
pubmed: 31849499
pmcid: 6910091