Assessment of real-world disease severity in patients with eosinophilic esophagitis in the United States

Evan S Dellon; Glenn T Furuta; Paul Feuerstadt; Priya Bansal; Todor I Totev; Oscar Patterson-Lomba; Hongjue Wang; Sanjana Sundaresan; Rajeev Ayyagari; Tao Fan; Jeanne Jiang; Mena Boules; Brian Terreri

doi:10.1177/17562848251347361

Assessment of real-world disease severity in patients with eosinophilic esophagitis in the United States

Therap Adv Gastroenterol. 2025 Jun 26:18:17562848251347361. doi: 10.1177/17562848251347361. eCollection 2025.

Authors

Evan S Dellon¹, Glenn T Furuta², Paul Feuerstadt^{3

4

5}, Priya Bansal^{6

7}, Todor I Totev⁸, Oscar Patterson-Lomba⁸, Hongjue Wang⁸, Sanjana Sundaresan⁸, Rajeev Ayyagari⁸, Tao Fan⁹, Jeanne Jiang⁹, Mena Boules⁹, Brian Terreri⁹

Affiliations

¹ Division of Gastroenterology and Hepatology, Department of Medicine, Center for Esophageal Diseases and Swallowing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
² Gastrointestinal Eosinophilic Diseases Program, Digestive Health Institute, Children's Hospital Colorado, Aurora, CO, USA.
³ Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
⁴ PACT Gastroenterology Center, Hamden, CT, USA.
⁵ Yale University School of Medicine, New Haven, CT, USA.
⁶ Asthma and Allergy Wellness Center, St. Charles, IL, USA.
⁷ Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁸ Analysis Group, Inc., Boston, MA, USA.
⁹ Takeda Pharmaceuticals USA, Inc., Lexington, MA, USA.

Abstract

Background: Eosinophilic esophagitis (EoE) disease severity is not typically reported in clinical practice.

Objectives: To assess real-world EoE disease severity (assessed by physicians and using an adapted Index of Severity for EoE (I-SEE)), physician/patient characteristics, healthcare resource utilization (HCRU), and treatment patterns among adolescents and adults with EoE in the USA.

Design: A noninterventional, retrospective, physician-reported medical chart review.

Methods: Gastroenterologists and allergists/immunologists from a US nationwide panel completed a chart review of medical records (December 2021-January 2022) of patients aged ⩾11 years with a histologically confirmed diagnosis of EoE. Baseline data were collected ⩾6 months before diagnosis of EoE (index date), and study outcomes were collected ⩾6 months after the index date. The study outcomes assessed the EoE diagnostic process, disease severity, treatment patterns, and EoE-related HCRU. All data were stratified by physician-assessed EoE disease severity (mild, moderate, or severe (clinical severity and markers of severity)); index date data were also mapped to an adapted I-SEE scoring system post hoc.

Results: Overall, 74 adolescents (11-17 years old) and 325 adults with EoE (⩾18 years old) were included; patient demographics were generally similar across severity levels. The presence of some symptoms (e.g., food impaction), allergic comorbidities (e.g., allergic rhinitis and food allergy (adults only)), duration between first symptom and index date, and the number of treatment lines received by patients increased with increasing physician-assessed EoE disease severity. However, fewer than 10% of adolescents and adults with EoE were assessed as having severe disease, and physician-assessed EoE disease severity was generally higher than the adapted I-SEE-assessed severity.

Conclusion: Real-world US data indicated that most patients with EoE had mild or moderate EoE disease severity. The duration between first symptom and index date and the number of treatment lines received by patients with EoE increased with worsening EoE disease severity.

Keywords: disease severity; eosinophilic esophagitis; index of severity for EoE; real-world data.