Atopic, allergic comorbidities prevalent among patients with eosinophilic esophagitis
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Key takeaways:
- 84% of the Part A cohort and 89.1% of the Part B cohort had an atopic or allergic comorbidity.
- The most common comorbidities were allergic rhinitis, nonfood allergies and food allergy.
SAN ANTONIO — A high proportion of patients with eosinophilic esophagitis also had simultaneous atopic or allergic comorbid conditions, according to data presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.
Eosinophilic esophagitis (EoE) is a chronic, progressive type II inflammatory disease, Marc E. Rothenberg, MD, PhD, director of the Cincinnati Center for Eosinophilic Disorders, said during his presentation.
“Patients with EoE have high rates of comorbid allergic disease, particularly food allergies, atopic dermatitis, asthma and allergic rhinitis,” Rothenberg, who also is a Healio Allergy/Asthma Peer Perspective Board Member, said.
The phase 3 LIBERTY-EoE-TREET study included two independent, 24-week, randomized, double-blind, placebo-controlled trials of dupilumab (Dupixent; Sanofi Genzyme/Regeneron), a monoclonal antibody that targets interleukin (IL)-4 and IL-13, in treating EoE in patients aged 12 years and older.
“Dupilumab is approved for the treatment of multiple type II inflammatory diseases including atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyposis, prurigo nodularis and EoE,” Rothenberg said.
Part A included patients who were randomly assigned 1:1 to 300 mg of subcutaneous dupilumab weekly or placebo. Part B included patients who were randomly assigned 1:1:1 to 300 mg of dupilumab weekly, 300 mg every other week, or placebo.
“The baseline demographics and disease characteristics were well balanced between the groups,” Rothenberg said.
In Part A of the study, which included 81 patients (mean age, 31.5 years; 60.5% male), 84% had a current atopic or allergic comorbidity. In Part B, which included 240 patients (mean age, 28.1 years; 63.8% male), 89.1% had a current atopic or allergic comorbidity.
The mean durations of EoE included 5 years for Part A and 5.6 years for Part B. Also, mean Dysphagia Symptom Questionnaire scores included 33.6 for Part A and 36.7 for Part B.
The most common comorbidities in Part A included allergic rhinitis (59.3%); allergies to medications, animals, plants, mold, dust mites and other nonfood items (48.1%); food allergies (44.4%); asthma (30.9%); and atopic dermatitis (18.5%).
“Sixteen percent had allergic conjunctivitis, 12% had contact dermatitis, 12% had hives, 10% had chronic rhinosinusitis and 1% had nasal polyps,” Rothenberg said.
The most common comorbidities in Part B included allergic rhinitis (62.3%), food allergies (53.6%), nonfood allergies (50.6%), asthma (37.7%) and atopic dermatitis (20.1%).
“Fifteen percent allergic conjunctivitis, 16% contact dermatitis, 18% with hives, 12% had rhinosinusitis and 2% had nasal polyps,” Rothenberg said.
Percentages of patients with currently resolved atopic or allergic comorbidities included 16% of those in Part A and 16.7% of those in Part B. The most common resolved comorbidities included asthma (4.9%), nasal polyps (3.7%) and hives (2.5%) in Part A and asthma (7.1%), atopic dermatitis (5.9%) and allergic conjunctivitis (2.9%) in Part B.
While 85.2% of the patients in Part A had at least one comorbid atopic or allergic condition other than EoE, 66.7% had more than one, 44.4% had more than two and 27.2% had more than three. Also, 2.5% reported more than eight.
Similarly, 90% of the patients in Part B had at least one comorbid atopic or allergic condition other than EoE, with 75.7% reporting more than one, 58.2% reporting more than two, 39.3% reporting more than three, and 0.8% reporting more than eight.
“Results were consistent between parts A and B at baseline,” Rothenberg said, “and these findings are in line with previous EoE studies.”