Shire, A Takeda Company, Lexington.
Shire, A Takeda Company, Cambridge, MA.
J Clin Gastroenterol. 2022 Feb 1;56(2):133-140. doi: 10.1097/MCG.0000000000001491.
This US-based, retrospective claims study aimed to investigate disease burden and treatment patterns in patients with eosinophilic esophagitis (EoE), and to compare health care resource use (HCRU) in patients with EoE and matched controls without EoE.
Patients with a diagnosis of EoE and ≥12 months of prediagnosis data were identified from the Truven Health MarketScan Research databases (January 2008 to September 2016) and followed up from the diagnosis date until termination of eligibility for a health plan. Patient clinical characteristics and HCRU were recorded in the 12 months before diagnosis; HCRU and treatment patterns were recorded during follow-up. HCRU in patients with EoE and matched controls was compared during the 12-month postdiagnosis period.
Among the 23,003 patients with EoE (mean age: 34.3 y; 64.8% male), gastroesophageal reflux disease was the most common prediagnosis condition (34.6%). After diagnosis, the most common off-label, first-line treatments were proton pump inhibitor monotherapy (52.8%) and topical corticosteroid monotherapy (21.5%). Overall, 3336 patients (14.5%) received at least 3 lines of off-label pharmacotherapy. Outpatient visits (recorded in 99.9% of patients on and postdiagnosis) were most frequently to gastroenterologists/pediatric gastroenterologists (49.5% prediagnosis, 72.6% on and postdiagnosis). Inpatient admissions and outpatient and emergency room visits were more likely in patients with EoE than in matched controls (P<0.0001).
Patients with EoE in the USA experience a high disease burden both before and after diagnosis, which requires significant HCRU. Our findings highlight the unmet need for adequate control of EoE-related symptoms.
这项基于美国的回顾性索赔研究旨在调查嗜酸性食管炎（EoE）患者的疾病负担和治疗模式，并比较 EoE 患者和无 EoE 匹配对照者的医疗资源使用（HCRU）。
从 Truven Health MarketScan Research 数据库（2008 年 1 月至 2016 年 9 月）中确定了诊断为 EoE 且有≥12 个月预诊断数据的患者，并从诊断日期随访至符合健康计划资格终止日期。在诊断前的 12 个月内记录患者的临床特征和 HCRU；在随访期间记录 HCRU 和治疗模式。比较 EoE 患者和匹配对照者在诊断后 12 个月内的 HCRU。
在 23003 例 EoE 患者中（平均年龄：34.3 岁；64.8%为男性），胃食管反流病是最常见的预诊断疾病（34.6%）。诊断后，最常见的非适应证一线治疗方法是质子泵抑制剂单药治疗（52.8%）和局部皮质类固醇单药治疗（21.5%）。总体而言，3336 例患者（14.5%）接受了至少 3 种非适应证药物治疗。门诊就诊（诊断前后 99.9%的患者均有记录）最常就诊的科室是胃肠病学家/儿科胃肠病学家（预诊断时为 49.5%，诊断后为 72.6%）。与匹配对照者相比，EoE 患者的住院和门诊及急诊就诊更有可能（P<0.0001）。
美国的 EoE 患者在诊断前后均经历着较高的疾病负担，这需要大量的 HCRU。我们的研究结果强调了满足 EoE 相关症状控制需求的重要性。
