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患者报告的嗜酸性粒细胞性食管炎症状和负担:来自真实世界临床实践的证据。

Patient-reported symptoms and burden of eosinophilic esophagitis: evidence from real-world clinical practice.

机构信息

BioPharmaceuticals Market Access and Pricing, AstraZeneca, 200 Orchard Ridge Dr, Gaithersburg, MD, 20878, USA.

BioPharmaceuticals Medical, AstraZeneca, 200 Orchard Ridge Dr, Gaithersburg, MD, 20878, USA.

出版信息

BMC Gastroenterol. 2024 Aug 3;24(1):246. doi: 10.1186/s12876-024-03334-4.

Abstract

BACKGROUND

Eosinophilic esophagitis is a chronic inflammatory disorder of the esophagus. This real-world study used patient and physician surveys to describe the clinical characteristics and disease burden of eosinophilic esophagitis-overall and in a subgroup of patients with dysphagia despite treatment.

METHODS

Data analyzed in this study were collected in 2020 from US and EU patients with eosinophilic esophagitis. Eligible patients were aged ≥ 12 years with a diagnosis of eosinophilic esophagitis, had an esophageal count of ≥ 15 eosinophils/high-power field at diagnosis, and were currently prescribed treatment for eosinophilic esophagitis.

RESULTS

Overall, 1001 patients were included, of whom 356 (36%) had dysphagia despite treatment. Demographics and clinical characteristics were similar in both populations. The severity of eosinophilic esophagitis was mild in more patients overall (69%) versus those with dysphagia despite treatment (48%). Patient disease history was similar in both populations, with some exceptions: common patient-reported symptoms were dysphagia (70% and 86%) and heartburn/acid reflux (55% and 49%), and common physician-reported symptoms were dysphagia (75% and 91%) and food impaction (46% and 52%). Treatment history was similar in both populations; overall, the most common treatments were proton pump inhibitors (83%) and topical corticosteroids (51%). Patients reported slightly more days with symptoms, higher impacts on activities of daily living, and slightly higher anxiety or depression in the dysphagia-despite-treatment population versus the overall population.

CONCLUSIONS

Eosinophilic esophagitis presents severe symptoms and comorbidities that substantially impact patients' well-being and quality of life. Greater awareness of and novel treatments for eosinophilic esophagitis are needed.

摘要

背景

嗜酸性粒细胞性食管炎是一种慢性食管炎症性疾病。本真实世界研究通过患者和医生调查,描述了嗜酸性粒细胞性食管炎的临床特征和疾病负担——总体情况以及在经过治疗仍有吞咽困难的患者亚组中。

方法

本研究分析的数据来自于 2020 年美国和欧盟的嗜酸性粒细胞性食管炎患者。符合条件的患者年龄≥12 岁,诊断为嗜酸性粒细胞性食管炎,在诊断时食管计数≥15 个嗜酸性粒细胞/高倍视野,并且目前正在接受嗜酸性粒细胞性食管炎的治疗。

结果

总体而言,纳入了 1001 名患者,其中 356 名(36%)经治疗后仍有吞咽困难。这两个人群的人口统计学和临床特征相似。在总体人群中,更多的患者的嗜酸性粒细胞性食管炎严重程度较轻(69%),而经治疗后仍有吞咽困难的患者严重程度较轻(48%)。两个人群的患者疾病史相似,但也存在一些差异:常见的患者报告症状为吞咽困难(70%和 86%)和烧心/胃酸反流(55%和 49%),常见的医生报告症状为吞咽困难(75%和 91%)和食物嵌塞(46%和 52%)。两个人群的治疗史相似;总体而言,最常见的治疗方法是质子泵抑制剂(83%)和局部皮质类固醇(51%)。与总体人群相比,经治疗后仍有吞咽困难的患者报告有更多的症状日数、对日常生活活动的影响更大,并且焦虑或抑郁程度略高。

结论

嗜酸性粒细胞性食管炎表现出严重的症状和合并症,这些症状和合并症极大地影响了患者的幸福感和生活质量。需要提高对嗜酸性粒细胞性食管炎的认识并开发新的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b57c/11297626/a087a0e44fd1/12876_2024_3334_Fig1_HTML.jpg

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