Eosinophilic Esophagitis (EoE)

Question 1

EoE – Prevalence

Answer 1

• 1 to 6 per 10,000, which equates to 0.06-0.1% or 200-330K in US.
• FDA has granted ODD for drugs in development suggesting patient population is <200k.
• More prevalent among Caucasian males.
• Typical onset is during childhood.

Question 2

EoE – Description

Answer 2

• Allergic inflammation of the esophagus caused by antigens; affects both children and adults.
• Th2-associated disease.
• Caused by eosinophils (type of white blood cell) which migrate to to the esophagus and infiltrate the epithelial lining. In healthy individuals, the esophagus is devoid of eosinophils.
• 10-20% of EoE patients also have IgE-mediated food allergies.

Question 3

EoE – Treatments

Answer 3

• Treated with diet and steroids.
• Rx Approval
&raquo_space; Regeneron/Sanofi’s Dupixent approved in May 2022 for EoE in patients 12+
• Rx Pipeline
&raquo_space; Takeda’s budesonide oral suspension (BOS) commenced Ph3 in Oct 2019; received CRL.
&raquo_space; Ellodi’s orally disintegrating tablet.

Question 4

EoE – Symptoms

Answer 4

• Difficulty swallowing
• Food impaction
• Stomach pains
• Regurgitation/vomiting
• Decreased appetite

Question 5

EoE – Companies developing therapies

Answer 5

• Adare (CDMO)
• Allakos ($8b) - ??
• Arena ($4.8b) - ??
• AstraZeneca - Fasenra (benralizumab) licensed from Kyowa Kirin; granted ODD
• Calypso Biotech (private)
• Dr Falk – launched Jorveza (budesonide oral dispersible tablet) in UK
• EsoCap AG (private) – topical delivery to upper GI tract
• Kyowa Kirin - see AZ above
• Quorum Innovations (private) - preclinical
• Regeneron – Dupixent received breakthrough designation results in Ph3 Part A
• Takeda – Budesonide oral suspension in Ph3