Unmet Treatment Needs in the Management of Patients With Eosinophilic Esophagitis: Insights From a Real-world Survey

OBJECTIVES: Eosinophilic esophagitis (EoE) is a chronic disease characterized by esophageal dysfunction and eosinophilic inflammation. This study examined current treatment dynamics and unmet treatment needs for patients with EoE.

METHODS: Data were derived from the Adelphi EoE Disease Specific Programme™, a real-world, cross-sectional survey of physicians and their patients in the United States (US) and Europe (France, Germany, Italy, Spain, United Kingdom) [July-December 2023]. Physicians reported data on current treatment for EoE, reasons for choice of treatment, and areas of treatment improvement. Analyses were descriptive.

RESULTS: Physicians (n=192) provided data on 1093 patients with EoE, of which 66% were male and 88% were White, and the mean age at EoE diagnosis was 33.1±14.4 years.

While 65% of patients received a proton pump inhibitor (PPI) as part of their current treatment regimen, PPIs were only considered the main treatment for 34% of patients (US: 61% and 30%; Europe: 68% and 37%). Steroids were part of their current treatment regimen for 62% of patients and were considered the main treatment for 47% of patients (US: 47% and 35%; Europe: 69% and 53%).

The top 3 physician-reported reasons for choice of current treatment were symptomatic relief (74%; US: 64%; Europe: 80%), improving quality of life (56%; US: 51%; Europe: 59%), and speed of onset of action (49%: US: 42%; Europe: 53%). Areas for improvement in current treatments were similar to the reasons for selection of the current treatments.

CONCLUSIONS: Despite most patients receiving a PPI, physicians still heavily depended on prescribing steroids as the main treatment for EoE. Physician treatment choices were driven by the patient perspective with symptomatic relief and improving quality of life as the top reasons. These aspects were also the top areas where improvements in current treatments are desired, indicating an unmet need based on current treatments.