Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder of the esophagus; symptoms include dysphagia, food impaction, abdominal pain, and nausea. EoE is one of several heterogeneous inflammatory conditions, known as eosinophil-associated diseases (EADs). EoE is a newly recognized disease associated with significant burden and upper GI morbidity that impair health-related quality of life (HRQoL). This real-world study characterizes the patient journey to diagnosis and treatment among EoE patients in France, Germany, Italy, Spain, and the United Kingdom (EU5).

Adelphi Real World Disease Specific Programmes (DSPs) are multinational, point-in-time surveys, completed by physicians for their patients, providing data regarding the real-world clinical practice for a range of chronic health conditions. This study used the Adelphi EoE DSP which collected information in 2020 from patients diagnosed with EoE and consulting for routine care in the EU5. Eligible patients included those aged ≥12 years with a physician confirmed EoE diagnosis, esophageal count of ≥15 EOS/high-power field (HPF) at diagnosis, and currently prescribed treatment for EoE.

Overall, 679 patients with EoE were included from EU5 from 128 physicians interviewed. Among those patients, mean age was 35.6 years and mean BMI was 23.7. Most patients (67%) were male, 54% were employed full-time, 24% were students, 1% were on leave/unemployed, and 13% needed caregiver support due to EoE. Most frequent EoE symptoms are shown in Figure. Mean age at EoE symptom onset was 30.5 years, mean time from EoE symptom onset to first HCP consult was 10.1 months, and from first consult to EoE diagnosis was 7.1 months; mean age at EoE diagnosis was 32.7 years. Most patients (83%) were diagnosed with either moderate (61%) or severe (22%) EoE; among those assessed using EREFS (30%), 79%, 87%, 78%, 77%, and 39% scored above Grade 0 in edema, rings, exudate, furrows, and stricture, respectively. After a mean of 3 years since diagnosis, 47% still had esophageal EOS ≥15/HPF though only 32% were considered moderate/severe EoE cases in the most recent assessment. Asthma (25%), allergic rhinitis (23%) and anxiety (13%) were the most common comorbidities.

EoE presents severe symptoms and comorbidities that could substantially impact patients’ daily living. Furthermore, patients face 18 months of wait from symptom onset to HCP consult and to receipt of an accurate diagnosis.