Alain M. Schoepfer1, Stevie Olsen2, Juby A Jacob-Nara3, Angela Khodzhayev4, Eilish McCann4
1Lausanne University Hospital, Lausanne, Switzerland; 2Adelphi Real World, Bollington, UK; 3Sanofi, Bridgewater, NJ, USA; 4Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
Objectives: Eosinophilic esophagitis (EoE) is a chronic type 2 inflammatory disease of the esophagus that substantially impairs quality of life and can result in chronic, progressive, and potentially irreversible functional abnormalities. The symptoms of EoE, including dysphagia, may affect the productivity, emotions, and social activity of those affected. The objective of this study was to describe the clinical characteristics, symptom burden, and impact on quality of life of patients with EoE.
Methods: The Adelphi Real World EoE Disease Specific Programme collected physician-reported patient record forms (PRFs) and patient- or caregiver-reported (self-reported, voluntary survey) data from a convenience sample of ≤ 12 consecutive patients with EoE per participating physician in the USA and EU5 (UK, France, Germany, Spain, Italy) from quarter 3 to quarter 4 of 2020. PRFs were completed for 422 patients with a physician-confirmed diagnosis of EoE and previous or current proton pump inhibitor treatment, with or without corticosteroid treatment, and with ongoing symptoms of dysphagia, including choking or food impaction. A total of 161 of these patients participated in the voluntary survey. Quality of life was assessed by a modified version of the 11-item EoE Impact Questionnaire (EoE-IQ), which measures the emotional, social, productivity, and sleep-related impacts of EoE on a score range of 1–5, with higher scores indicating greater impairment.
Results: Of the 422 patients, 200 (47%) had additional physician-reported type 2 inflammatory comorbidities, including asthma (98 [23%]), atopic dermatitis (86 [20%]), hand and foot eczema (42 [10%]), allergic rhinitis (135 [32%]), pollen food allergy syndrome (42 [10%]), and peanut allergy (48 [11%]). Of the 161 patients who participated in the voluntary survey, symptoms reported in the past 7 days (other than dysphagia) included chest pain (41% of patients; mean [SD] days with symptom 0.9 [1.52]), stomach pain (54%; 1.2 [1.62]), heartburn (69%; 1.8 [2.02]), food or liquid coming back up into throat (57%; 1.3 [1.91]), and vomiting (17%; 0.4 [1.12]). Quality of life impairment in the past 7 days was also reported, with mean (SD) total EoE-IQ score 1.9 (0.78). This included mean EoE-IQ subscores for being bothered (2.22), embarrassed (1.86), worried by trouble swallowing (2.19), worried by choking (2.15), worried by trouble swallowing while in a public place (2.06), social activities that involve eating food (1.85), relationships with family (1.59), relationships with friends (1.65), keeping up with things at school or work (1.59), missing school or work (1.46), and sleep disruption (1.62). Similar results were seen across age groups of adolescents (aged 12–17 years) and adults (aged ≥ 18 years).
Conclusions: In this real-world study, patients with EoE experienced multiple symptoms beyond dysphagia which had a significant impact on various aspects of quality of life, despite current clinical management. In addition to EoE, almost half of patients had at least 1 additional type 2 comorbidity as reported by their physicians.
Reference: PAGE 30 (2022) Abstr 10191 [www.page-meeting.org/?abstract=10191]
Poster: Drug/Disease Modelling - Other Topics