Allergy, Asthma CE/CME ACCREDITED Watch Time: 63 mins

touchCONGRESS Improving outcomes for patients with eosinophilic oesophagitis: What do the data from AAAAI 2022 tell us?

Watch this two-part activity exploring recent data on eosinophilic oesophagitis from the annual meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) 2022.

Part 1: Watch leading gastroenterologist, Dr Evan Dellon, review key data from AAAAI 2022 Watch now

Part 2: Hear from three leading experts in eosinophilic oesophagitis, as they discuss what these data may mean for global and regional practice Select an interview

  • Part 1: Data Review
CE/CME ACCREDITED Next Chapter
Introduction
Complex pathophysiology and manifestations of EoE
Chronic nature of EoE and the impact on patient quality of life
Emerging treatments for EoE and their impact on clinical practice
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  • Part 2: Expert interviews
Dr Evan Dellon
Watch Time: 09:49
University of North Carolina School of Medicine, Chapel Hill, NC, USA

Dr Evan Dellon considers the latest data on EoE from AAAAI 2022 and how this might impact current approaches to patient care.

 
Dr Stuart Carr
Watch Time: 08:37
Snö Asthma & Allergy Centre, Abu Dhabi, UAE

Dr Stuart Carr considers the latest data on EoE from AAAAI 2022 and how this might impact current approaches to patient care.

 
Dr Alexandra Papadopoulou
Watch Time: 08:03
National and Kapodistrian University of Athens, Greece

Dr Alexandra Papadopoulou considers the latest data on EoE from AAAAI 2022 and how this might impact current approaches to patient care.

 
 
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Overview & Learning Objectives
Overview

In this activity, Dr Evan Dellon reviews key data from the AAAAI 2022 Annual Meeting on eosinophilic oesophagitis. Dr Dellon is interviewed alongside Dr Stuart Carr and Dr Alexandra Papadopoulou, and our three experts share their personal insights on how these data may impact clinical practice.

This activity is jointly provided by USF Health and touchIME. read more

Target Audience

This activity has been designed to meet the educational needs of adult and paediatric gastroenterologists, adult and paediatric allergists/immunologists, paediatricians, advanced nurse practitioners, physician assistants and practice nurses involved in the management of patients with eosinophilic oesophagitis.

Disclosures

USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

Faculty

Dr Evan Dellon discloses: Consultant for Abbott Laboratories, AbbVie, Adare/Ellodi Pharmaceuticals, Aimmune, Allakos, Amgen, Arena Pharmaceuticals, AstraZeneca, Avir Pharma, Biorasi, Calypso Biotech, Celgene/Receptos/Bristol Myers Squibb, Celldex Therapeutics, Eli Lilly and Co., EsoCap Biotech, GlaxoSmithKline, Gossamer Bio, InveniAI, Landos Biopharma, Lucid Diagnostics, Morphic Therapeutic, Nutricia, Parexel Informatics/Calyx Solutions, Phathom Pharmaceuticals, Regeneron Pharmaceuticals, Revolo Biotherapeutics, Robarts/Alimentiv Inc., Salix Pharmaceuticals, Sanofi, Shire/Takeda and Target RWE. Grants/research support from Adare/Ellodi Pharmaceuticals, Allakos, Arena Pharmaceuticals, AstraZeneca, Banner and Holoclara, Inc., Celgene/Receptos/Bristol Myers Squibb, GlaxoSmithKline, Meritage Pharma, Miraca Life Sciences, Nutricia, Regeneron Pharmaceuticals and Shire/Takeda.

Dr Stuart Carr discloses: Speaker’s bureau fees from Sanofi, Tribute/Aralez Pharmaceuticals.

Dr Alexandra Papadopoulou discloses: Advisory board or panel fees from Adare Pharmaceuticals, Dr. Falk Pharma GmbH and Specialty Therapeutics (relationships terminated). Grant/research support from AbbVie, Dr. Falk Pharma GmbH and Takeda; AstraZeneca and United Pharmaceuticals. Speaker’s bureau fees from Nestle and Petsiavas; Cross Pharmaceuticals and Uni-Pharma S.A. Pharmaceutical Laboratories (relationships terminated).

Content reviewer

Patrick Brady, MD. has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Director

Kathy Day has no financial interests/relationships or affiliations in relation to this activity.

USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

If you have questions regarding credit please contact cpdsupport@usf.edu 

Accreditations

Physicians

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu)

Advanced Practice Providers

Physician Assistants may claim a maximum of 1.0 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

Date of original release: 12 April 2022. Date credits expire: 12 April 2023.

If you have any questions regarding credit please contact cpdsupport@usf.edu

Learning Objectives

After watching this activity, participants should be better able to:

  • Summarize recent clinical evidence on the complex pathophysiology and manifestations of eosinophilic oesophagitis (EoE)
  • Outline the chronic nature of EoE and the impact on patient quality of life
  • Assess the latest data for emerging treatments for EoE and their impact on clinical practice
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Question 1/5
Which of the following are early-life risk factors that would heighten your vigilance for the development of EoE?

EoE, eosinophilic oesophagitis; NICU, neonatal intensive care unit.
Correct

A nationwide prospective study using Danish health and administrative registries was conducted to investigate the impact of perinatal exposures on the risk of developing EoE. In this study, both preterm delivery and NICU admission were the early-life risk factors most strongly associated with the development of EoE. 

Abbreviations

EoE, eosinophilic oesophagitis; NICU, neonatal intensive care unit.

Reference

Kurt G, et al. J Allergy Clin Immunol. 2022;149:AB68.

Question 2/5
Your 12-year-old patient presents to the allergy clinic with worsening atopic dermatitis. She complains of vomiting and has a history of food allergy. Based on data presented at the AAAAI 2022 annual meeting, what is a key question you could ask the patient to rule in or out EoE?

AAAAI, American Academy of Allergy, Asthma & Immunology; EoE, eosinophilic oesophagitis.
Correct

Patients with EoE have a high degree of eosinophil-associated disease overlap and increased disease burden.1 EoE should be considered in patients with atopy if there are persistent upper GI symptoms, such as dysphagia and food impaction.2

In a case-controlled study, adult patients with atopic disease had a high prevalence of dysphagia to solid foods compared with healthy controls (28.4% versus 2.0%, p<0.001). In addition, an increased number of concomitant atopic conditions was associated with an increased risk of dysphagia (OR 5.27, p=0.019).3

Abbreviations

EoE, eosinophilic oesophagitis; GI, gastrointestinal; OR, odds ratio.

References

  1. Kwiatek J, et al. J Allergy Clin Immunol. 2022;149:AB121. 
  2. Hong C-H, et al. J Cutan Med Surg. 2018;22(1_suppl):17S–20S.
  3. Eid R, et al. J Allergy Clin Immunol. 2022;149:AB210.
Question 3/5
How may the outcomes of a recent longitudinal study presented at the AAAAI 2022 annual meeting by Aceves S, et al on parent- and child patient-reported outcomes over time inform your approach to assessing the impact of EoE in children?

AAAAI, American Academy of Allergy, Asthma & Immunology; EoE, eosinophilic esophagitis.
Correct

Results from a longitudinal, multicentre, prospective study that investigated the relationship between parent- and child-patient-reported outcomes in EoE over time, showed a high correlation between parent- and child-reported PEESSv2.0 (r=0.83). In addition, parent- and child patient-reported EoE-QL correlated across the ages (r=0.74). 

Abbreviations

EoE, eosinophilic esophagitis; EoE-QL, EoE-Quality of Life; PEESSv2.0, Pediatric Eosinophilic Symptom Score, version 2.0.

Reference

Aceves S, et al. J Allergy Clin Immunol. 2022;149:AB205.

Question 4/5
In part B of the LIBERTY EoE TREET trial, which of the following statements best reflects the results for patients with EoE treated with dupilumab when compared with placebo?

EoE, eosinophilic oesophagitis.
Correct

LIBERTY EoE TREET was a three-part, placebo-controlled, phase III trial that assessed efficacy and safety of dupilumab in adolescents/adults with EoE.

In part B, efficacy outcomes at week 24 were:

  • Histologic remission: 58.8% dupilumab versus 6.3% placebo (p<0.0001) 
  • Clinical outcomes: 23.78-point improvement in DSQ score for dupilumab versus 13.86 for placebo (p<0.0001)

Abbreviations

DSQ, Dysphagia Symptom Questionnaire; EoE, eosinophilic oesophagitis.

Reference

Rothenberg M, et al. J Allergy Clin Immunol. 2022;149:AB312.

Question 5/5
Your patient is receiving dupilumab treatment for atopic dermatitis and also has comorbid EoE. Based on recent data presented at the AAAAI 2022 annual meeting, what would be the clinical outcome expectations you would communicate to the patient?

AAAAI, American Academy of Allergy, Asthma & Immunology; EoE, eosinophilic oesophagitis.
Correct

In a retrospective chart review, dupilumab appeared to be effective in controlling the primary atopic condition that it was prescribed for in patients who also had a clinical diagnosis of EoE. Dupilumab also demonstrated an improvement in both histology and symptom control of EoE, as well as the ability to reduce medication/expand diet.

Abbreviation

EoE, eosinophilic oesophagitis.

Reference

Spergel B, et al. J Allergy Clin Immunol. 2022;149:AB202.

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