Eosinophilic esophagitis patients report substantial disease burden comparable to more systemic immune-mediated diseases

Background: Eosinophilic esophagitis (EoE) is a chronic Type 2 inflammation. One might assume that the disease-related impact on daily life is significantly smaller, given the relatively localized disease distribution, compared to more systemic immune-mediated diseases. This study aimed to evaluate the disease burden among various immune-mediated diseases, including EoE, inflammatory bowel disease (IBD), systemic sclerosis (SSC) and lupus erythematosus (SLE). Methods: A web-based questionnaire assessed baseline characteristics, general quality of life and disease-related impairment across several subdomains, including work, leisure and social life. The surveys were distributed by the respective Swiss patient organizations. Results: Overall, 608 patients participated in the survey (EoE: 92; IBD: 407; SSC: 69; and SLE: 40). Although the overall perceived general impairment in everyday life, measured on a numeric rating scale (NRS), was higher in Crohn's disease (CD), SSC, and SLE patients compared to EoE (median 3, IQR 2-6), there was no significant difference compared to ulcerative colitis (UC) (median 4, IQR 2-6, p = 0.31) or IBD patients overall (median 5, IQR 3-6; p = 0.05; Fig. 1a). Impairment in EoE was most pronounced and in the subdomain of leisure, consistent with other investigated diseases. Disease-related impairment was higher in women versus men and in patients with a longer diagnostic delay across all diseases. Conclusions: EoE patients' perceived impairment in everyday life, particularly within subdomains such as leisure, is substantial and comparable to that experienced by patients with other immune-mediated disease states, including IBD. Notably, patient-perceived impairment was higher among female EoE patients and those with a longer diagnostic delay.