Eosinophilic Esophagitis

Not an actual patient.

Eosinophilic esophagitis (EoE) is a chronic, local, immune-mediated, inflammatory disease localized in the esophagus.¹

EoE is characterized by eosinophilic inflammation, which is thought to be triggered by exposure to aero- or food allergens, and can lead to esophageal dysfunction.^1,2

Epidemiology

The incidence and prevalence of eosinophilic esophagitis have steadily increased over time. Approximately 1 in 2000 people in the U.S. live with EoE.^2,3 EoE is often accompanied by other comorbidities, and has a strong association with atopic disease.^1,4,5 Clinicians should maintain a high index of suspicion of EoE, regardless of age, race or sex; however, EoE is approximately twice as common in men vs women and more common among White people, with symptoms varying by age.⁶

Diagnosis

The diagnosis of EoE is dependent on clinical, endoscopic, and histologic findings. These findings include symptoms of esophageal dysfunction; endoscopic findings of rings, furrows, exudates, edema, stricture, narrowing, and crepe-paper mucosa; and eosinophilic infiltration, which is defined as ≥15 eosinophils per high power field (eos/hpf) on an esophageal biopsy, that is isolated to the esophagus.⁷ A diagnosis of EoE is not reliant on prior response to proton pump inhibitors (PPIs). EoE should be suspected if a patient presents with chronic signs and symptoms of esophageal dysfunction such as: dysphagia, food impaction, food refusal, failure to progress with food introduction, heartburn, regurgitation, vomiting, chest pain, odynophagia, abdominal pain and malnutrition.

Pathophysiology

The pathophysiology of EoE involves the production of pro-inflammatory cytokines that promote the recruitment and proliferation of immune effector cells, such as eosinophils, at the site of inflammation. This chronic inflammation, localized to the esophagus can disrupt normal epithelial integrity.^2,8,9 If left untreated, the disease can progress to a fibrostenotic phenotype with esophageal remodeling and dysmotility.^1,10,11

Navigating EoE

The symptoms and impact of EoE can vary by age.^1,12 Infants and toddlers with EoE may experience vomiting, food refusal, choking with meals, and sleep disturbances. Children may experience dysphagia, choking and gagging with certain foods, food impactions, pain, nausea and vomiting, sleep disturbances, and decreased appetite. Adults may report dysphagia, food impaction, food avoidance, intractable heartburn, regurgitation, and chest pain. Surveys of patients with EoE suggest their greatest concerns relate to difficulty swallowing and the overall impact on eating.^13,14 Symptomatic improvement has been shown to be a key endpoint of therapy.^15,16

Lucendo AJ, Molina-Infante J, Arias Á, et al. United European Gastroenterol J. 2017;5:335-358.
O'Shea KM, Aceves SS, Dellon ES, et al. Gastroenterology. 2018;154:333-345.
American College of Allergy, Asthma, & Immunology. Eosinophilic Esophagitis. https://acaai.org/allergies/allergic-conditions/eosinophilic-esophagitis. Updated May 23, 2022.
Leigh LY and Spergel JM. Ann Allergy Asthma Immunol. 2019;122:65-72.
Capucilli P, Cianferoni A, Grundmeier RW, et al. Ann Allergy Asthma Immunol. 2018;121:711-716.
Mansoor E and Cooper GS. Dig Dis Sci. 2016;61:2928-2934.
Dellon ES, Liacouras CA, Molina-Infante J, et al. Gastroenterology. 2018;155:1022-1033.
Wechsler JB and Bryce PJ. Gastroenterol Clin North Am. 2014;43:281-296.
Hill DA and Spergel JM. Curr Allergy Asthma Rep. 2016;16:9.
Dellon ES and Liacouras CA. Gastroenterology. 2014;147:1238-1254.
Hirano I and Aceves SS. Gastroenterol Clin North Am. 2014;43:297-316.
Carr S, Chan ES, Watson W. Allergy Asthma Clin Immunol. 2018;14(Suppl 2):103-113.
Taft TH, Kern E, Keefer L, et al. J Clin Gastroenterol. 2011;45:769-774.
Safroneeva E, Coslovsky M, Kuehni CE, et al. Aliment Pharmacol Ther. 2015;42:1000-1010.
Balsiger L, Hafner D, Kuehni C, et al. Swiss Med Weekly. 2018;148(Suppl 232):16S.
Safroneeva E, Balsiger L, Hafner D, et al. Aliment Pharmacol Ther. 2018;48:1082-1090.

Medication Resources

Eohilia^™

(budesonide oral suspension)

Prescribing Information

Upcoming & Past Conferences in Gastroenterology

Upcoming
Past

Crohn's & Colitis Congress (CCC), 2025

February 6 - 8, 2025 | Link to Event

Annual conference for a multidisciplinary community of practitioners and researchers focusing on inflammatory bowel disease (IBD) by pairing best practices in clinical care with innovative research.

European Crohn's and Colitis Organisation (ECCO), 2025

February 19 - 22, 2025 | Link to Event

Annual global congress structured around basic science, traditional medicine and clinical sessions given by some of the world's top GI specialists.

Annual Meeting American Academy of Allergy Asthma and Immunology (AAAAI), 2025

February 28 - March 3, 2025 | Link to Event

Premier global educational event for allergists and immunologists, with thousands of attendees each year, discussing allergies, asthma, and immune deficiency disorders.

American Society for Parenteral and Enteral Nutrition (ASPEN), 2025

March 22 - 25, 2025 | Link to Event

Annual global conference for interdisciplinary, clinical nutrition leaders, providing the latest in clinical nutrition research, education, and products.

Digestive Disease Week (DDW), 2025

May 3 - 6, 2025 | Link to Event

Global meeting for physicians, researchers, and industry in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery.

Advances in Inflammatory Bowel Diseases (AIBD), 2024

December 9 - 11, 2024

An all-encompassing event providing real-world clinical education, case studies and new evidence-based approaches in IBD management.

World Congress of Pediatric Gastroenterology, Hepatology and Nutrition (WCPGHAN), 2024

December 4 - 7, 2024

Annual forum for participants to learn about the latest advances in pediatric gastroenterology, hepatology, and nutrition, and to discuss current topics in clinical applications.

Gattex® (teduglutide)

Long-Term Safety and Effectiveness of Teduglutide in Pediatric Patients with Short Bowel Syndrome-Associated Intestinal Failure: An Observational, Prospective, Multicenter Registry

Professional Society for Health Economics and Outcomes Research (ISPOR Europe), 2024

November 17 - 20, 2024

The conference program centers on the importance of scientific evidence in understanding and improving the health and well-being of people across the globe.

North American Society For Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN), 2024

November 6 - 9, 2024

Annual forum for participants to learn about the latest advances in pediatric gastroenterology, hepatology, and nutrition, and to discuss current topics in clinical applications.

Eohilia® (budesonide)

Safety of short-term therapy with budesonide oral suspension for eosinophilic esophagitis: an integrated analysis of adolescent safety data

American College of Gastroenterology (ACG), 2024

October 25 - 30, 2024

Premier event for clinicians and the general public about digestive disorders and the latest trends in GI technology and therapeutics.

Entyvio® (vedolizumab)

Investigating the Relationship Between Endoscopic Characteristics and Treatment Choice for Patients with Ulcerative Colitis Using a Real-world Data Set Linked to Endoscopic Videos Evaluated with Computer Vision
Comparative Efficacy of Biologics for the Induction of Clinical Remission and Response in Biologic-naïve Patients with Moderate to Severe Crohn’s Disease: Outcomes from Frequentist and Bayesian Network Meta-analyses
Comparative efficacy and safety of subcutaneous vedolizumab versus other targeted inflammatory bowel disease therapies in patients with moderate to severe ulcerative colitis: a network meta-analysis
Real-World Effectiveness and Onset of Action of Vedolizumab as a First-Line Biologic in Biologic-Naïve Patients With Ulcerative Colitis
Identification of Moderate Disease Severity Definitions for Crohn’s Disease and Ulcerative Colitis: A Review of Phase 3 Trials of Pharmacological Therapy

Eohilia® (budesonide)

Effect of budesonide oral suspension on dysphagia symptom resolution and time to first dysphagia symptom response in eosinophilic esophagitis: post hoc analysis of phase 2 and phase 3 trial placebo-controlled trials
Effect of budesonide oral suspension on dysphagia symptom outcomes in patients with eosinophilic esophagitis: a pooled post hoc analysis of data from a phase 2 and a phase 3 trial

American College of Allergy, Asthma & Immunology (ACAAI), 2024

October 24 - 28, 2024

Global meeting featuring thought leaders from around the world focused on advancing patient care in allergy and immunology.

Eohilia® (budesonide)

Effect of budesonide oral suspension on dysphagia severity outcomes in patients with eosinophilic esophagitis
Effect of corticosteroid use on outcomes in patients with eosinophilic esophagitis receiving budesonide oral suspension

Academy of Managed Care Pharmacy Nexus (AMCP Nexus), 2024

October 14 - 17, 2024

Annual event with more than 2,500 members and non-members of the AMCP to engage on the latest innovations and most intentional networking in managed care pharmacy.

Entyvio® (vedolizumab)

Development of a risk adjustment model in commercially insured patients with inflammatory bowel disease

American College of Clinical Pharmacy (ACCP), 2024

October 12 - 15, 2024

Annual event dedicated to excellence in clinical pharmacy practice, research, and education.

United European Gastroenterology Week (UEGW), 2024

October 12 - 15, 2024

Global congress for researchers from around the world to present their findings on gastroenterology and digestive health.

Gattex® (teduglutide)

Long-term Safety and Effectiveness of Teduglutide in Paediatric Patients with Short Bowel Syndrome-Associated Intestinal Failure: an Observational, Prospective, Multicentre Registry

Pediatric Intestinal Failure and Rehabilitation Symposium (PIFRS), 2024

September 26 - 28, 2024

Global meeting designed to bring together international and national experts in the multidisciplinary care of the intestinal failure patient.

Gattex® (teduglutide)

Long-term Safety & Effectiveness of Teduglutide in Pediatric Patients with Short Bowel Syndrome-Associated Intestinal Failure: A Multicenter Registry

Gastroenterology and Hematology Advanced Practice Providers (GHAAP), 2024

September 12 - 14, 2024

Conference specifically designed by advanced practice providers (APPs) for the purpose of meeting the educational needs of APPs who specialize in the management of patients with GI disorders and chronic liver disease.

Entyvio® (vedolizumab)

Proactive Patient Engagement to Promote Representative Patient Populations for Future Trials of Dual Targeted Therapies in Inflammatory Bowel Diseases

Eohilia® (budesonide)

Safety of short-term therapy with budesonide oral suspension for eosinophilic esophagitis: an integrated analysis of phase 2 and 3 clinical studies

American College of Clinical Pharmacology (ACCP), 2024

September 8 - 10, 2024

Annual congress to improve global health by advancing the frontiers of

clinical pharmacology

Eohilia® (budesonide)

Effect of food on the pharmacokinetics, safety and tolerability of budesonide oral suspension in healthy adults: a randomized phase 1 study

European Society for Clinical Nutrition & Metabolism Congress (ESPEN), 2024

September 7 - 10, 2024

Annual global congress dedicated to clinical nutrition and metabolism, including basic and clinical research, education, and organization of consensus statements about clinical care.

Gattex® (teduglutide)

Long-term Safety of Teduglutide in Paediatric Patients with Short Bowel Syndrome-Associated Intestinal Failure: an Observational, Prospective, Multicentre Registry
Long-term Effectiveness of Teduglutide in Paediatric Patients with Short Bowel Syndrome-Associated Intestinal Failure: an Observational, Prospective, Multicentre Registry

Digestive Disease Week (DDW), 2024

May 18 - 21, 2024

Global meeting for physicians, researchers, and industry in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery.

Gattex® (teduglutide)

Short bowel syndrome patient experience: a mixed-method study leveraging Inspire, an online community platform.

Entyvio® (vedolizumab)

Proactive patient engagement to promote representative patient populations for future trials of dual targeted therapies in inflammatory bowel diseases.
Machine Learning-Based Precision Medicine Approach Identifies Specific Responder Sub-Populations in the Vedolizumab treated patients by Dynamic Clustering of PRO Data: Post Hoc Analysis of VARSITY and GEMINI Dataset.
Biologic Therapy Sequencing in Ulcerative Colitis: A Real-World Observational Study of Second-Line Therapy After Vedolizumab [encore].
Real-world clinical effectiveness and safety of vedolizumab and ustekinumab in biologic-naïve patients with Crohn's disease by disease location: Results from the EVOLVE Expansion study [encore].

Eohilia® (budesonide)

Safety of short-term therapy with budesonide oral suspension for eosinophilic esophagitis: an integrated safety analysis of four phase 1–3 clinical studies.

Motegrity® (prucalopride)

Diagnostic journey of patients with chronic idiopathic constipation in the USA: analysis from a cross-sectional observational study.

Professional Society for Health Economics and Outcomes Research (ISPOR), 2024

May 5 - 8, 2024

Leading global conference discussing how to establish, incentivize, and share value sustainable for health systems, patients, and technology developers.

Academy of Managed Care Pharmacy (AMCP), 2024

April 15 - 18, 2024

Large assembly of pharmacy and healthcare professionals dedicated to the issues of managed care pharmacy, offering immersive education sessions and keynote presentations.

Campaign Urging Research for Eosinophilic Disease (CURED), 2024

April 4 - 7, 2024

International meeting concerning the field of Eosinophilic Gastrointestinal Disorders, including EoE and other eosinophilic diseases.

Eohilia® (budesonide)

Improved histopathologic features in patients with eosinophilic esophagitis: data from a phase 3, randomized, placebo-controlled trial of budesonide oral suspension

American Society for Parenteral and Enteral Nutrition (ASPEN), 2024

March 2 - 5, 2024

Annual global conference for interdisciplinary, clinical nutrition leaders, providing the latest in clinical nutrition research, education, and products.

Annual Meeting American Academy of Allergy Asthma and Immunology (AAAAI), 2024

February 23 - 26, 2024

Premier global educational event for allergists and immunologists, with thousands of attendees each year, discussing allergies, asthma, and immune deficiency disorders.

European Crohn's and Colitis Organisation

February 21 - 24, 2024

Annual global congress structured around basic science, traditional medicine and clinical sessions given by some of the world's top GI specialists.

Crohn's & Colitis Congress (CCC), 2024

January 25 - 25, 2024

Annual conference for a multidisciplinary community of practitioners and researchers focusing on inflammatory bowel disease (IBD) by pairing best practices in clinical care with innovative research.

Videos

Watch videos focused on Eosinophilic Esophagitis (EoE).