S618 Unmet Needs Among Patients with Eosinophilic Esophagitis Despite Biologic Use

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Introduction: Eosinophilic esophagitis (EoE) is a chronic, progressive, type 2 inflammatory disease characterized by symptoms of esophageal dysfunction and eosinophilic inflammation. Recent changes in the EoE treatment landscape include the emergence of biologics and development of other novel therapies; however, it is unknown whether treatment needs have been fully met by these pharmacological advances. This real-world analysis was conducted to explore the unmet need in EoE among patients receiving a biologic as their main treatment in the Adelphi EoE Disease Specific Programme (DSP). Methods: Data were drawn from the DSP, a real-world, cross-sectional survey of physicians and their patients with confirmed diagnosis of EoE in the US, UK, and EU (France, Germany, Italy, Spain) from July through December 2023. Analyses were based on clinical data drawn from medical records, and included treatment type, patient symptoms, and adaptive eating behaviors. Analyses were descriptive with results presented for the subset of patients using biologics, which represents the most advanced pharmacologic treatment available. Results: Physicians provided data on 176 patients (31% female; mean age, 35.9 years; 83% White; 70% US based vs 30% Europe based) who received biologics (including anti-interleukin-4 receptor alpha [IL-4Rα] antibody, anti-IL5 antibody, anti-IL13 antibody, anti-thymic stromal lymphopoietin antibody, and anti-Immunoglobulin E antibody) as their main treatment for EoE (Table 1). Although an anti-IL-4Rα antibody is the only approved biologic for EoE, physicians indicated that the current biologic treatment noted was the “main” treatment for EoE. In total, 39% (n=69) of patients had a concurrent diagnosis of asthma. Although physicians felt that most patients (75%) experienced symptomatic relief from their current treatment, they noted that patients had persistent adaptive eating behaviors (Figure 1). Conclusion: Despite experiencing symptomatic improvements following biologic use, most patients with EoE continue to adapt their eating behavior, suggesting an unmet need for optimized symptom control and accurate assessment of symptom resolution with available advanced therapies.Figure 1.: Adaptive behaviors in post-biologic treatment Note: The question asked was “Does the patient use any accommodation methods to cope with their symptoms?”. Table 1. - Patient Characteristics Age, years n=176 Mean (SD) 35.9 (14.7) Sex, n (%) n=176 Male 121 (69) Female 55 (31) BMI n=175 Mean (SD) 24.2 (3.4) Ethnicity, n (%) n=162 White 135 (83) Black or African American/African or Caribbean 13 (8) East or Southeast Asian 7 (4) South Asian (Indian subcontinent) 4 (2) Middle Eastern or North African 2 (1) Other 3 (2) Smoking status, n (%) n=176 Current smoker 14 (8) Ex-smoker 37 (21) Never smoked 116 (66) Don’t know 9 (5) Current diagnosis of asthma, n (%) n=176 Yes 69 (39) Not currently, but diagnosed in the past 0 (0) No 107 (61) Duration of current treatment, days n=155 Mean (SD) 312.9 (294.1) Biologic treatments, n (%) n=176 Anti-IL-4Rα antibody 145 (82) Anti-IL-5 antibody 19 (11) Anti-IL-13 antibody 5 (3) Anti-thymic stromal lymphopoietin antibody 1 (1) Anti-immunoglobulin E antibody 6 (3) BMI, body mass index; SD, standard deviation.

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