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

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.