Overview
How the Patient Experience Should Inform Treatment Selection: Reframing Expectations in EoE for HCPs and Patients
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Eosinophilic esophagitis (EoE) has been steadily increasing in prevalence and incidence over the past three decades. Today, EoE has evolved from a rare case-reportable condition to a disease that is commonly encountered in the clinic and endoscopy suite and is a major cause of upper gastrointestinal morbidity and increasing healthcare costs.
Delays in diagnosis persist and management of the disease can be complex. While significant advances in the treatment of EoE have been made, studies show many clinicians continue to prescribe therapies with limited effectiveness. Moreover, clinicians often forego efforts to engage patients with EoE in shared decision-making, despite evidence demonstrating that patients who are participate in decisions around treatment report higher levels of treatment satisfaction.
To provide patient-centered EoE care, clinicians must recognize and navigate the diagnostic and management challenges of the condition and tailor therapy selection considerate of patient preferences and values. This education uses case vignettes, expert reinforcements of best practices, and shareable patient education materials to support clinicians in delivering personalized care for their patients with EoE.
This activity is designed for gastroenterologists, allergists, immunologists, nurse practitioners, physician assistants, dietitians, and nurses who care for patients with EoE.
EoE, an immune-mediated, chronic disease characterized by esophageal eosinophilia, is a major cause of upper gastrointestinal morbidity and increasing healthcare costs. Indeed, EoE is the leading cause of food impaction, the main cause of dysphagia among children and young adults in Europe and North America, and the most prevalent cause of chronic or recurrent esophageal symptoms after gastroesophageal reflux disease (GERD). Moreover, this chronic inflammation may progress into fibrous remodeling of the esophageal wall with collagen deposition, fibrosis of the lamina propria, and development of esophageal strictures and narrow-caliber esophagus as the disease evolves from childhood into adulthood. However, a number of gaps in care of EoE have been observed. First, EoE diagnosis can be challenging for clinicians, as there is substantial phenotypic variability in presentation based on age and duration of disease. In addition, many clinicians do not view EoE as a chronic disease even though relapse is inevitable in almost all patients. Further, despite the need for coordinated multidisciplinary care, there remains a substantial lack of collaboration and interdisciplinary communication. In order to assist clinicians in the recognition of EoE diagnosis, management, and the burdens of the disease experienced by patients, this educational activity will present a series of video vignettes between a patient and two experts in EoE to share first-hand, real-world experiences facing patients with EoE. In the context of these exchanges, faculty will review evidence-based recommendations and provide meaningful tips and practical resources on how to approach patient-centric decision making around treatment.
Upon completion of this activity, learners will be able to:
• Explain how the chronic, inflammatory nature of EoE underlies disease symptoms and the need for long-term therapy
• Optimize integration of available and emerging therapies within comprehensive, multidisciplinary management plans for patients with EoE
• Interpret safety and efficacy data for available and emerging therapies for EoE
• Formulate personalized treatment strategies considerate of patient characteristics, comorbidities, disease severity, and preferences
• Explain how the chronic, inflammatory nature of EoE underlies disease symptoms and the need for long-term therapy
• Optimize integration of available and emerging therapies within comprehensive, multidisciplinary management plans for patients with EoE
• Interpret safety and efficacy data for available and emerging therapies for EoE
• Formulate personalized treatment strategies considerate of patient characteristics, comorbidities, disease severity, and preferences
This educational activity is presented in collaboration with Rush University Medical Center and Academy for Continued Healthcare Learning (ACHL).
Supported by an educational grant from Takeda Pharmaceuticals U.S.A., Inc.
Gary W. Falk, MD, MS
Professor Emeritus of Medicine
Division of Gastroenterology
University of Pennsylvania Perelman School of Medicine
Philadelphia, PA
Professor Emeritus of Medicine
Division of Gastroenterology
University of Pennsylvania Perelman School of Medicine
Philadelphia, PA
Katherine Alexander, MHS, PA-C
Physician Assistant
Division of Gastroenterology
Hospital of the University of Pennsylvania
Philadelphia, PA
Alexis Munoz, BSN
Registered Nurse
Rush University Medical Center
It is the policy of the Interprofessional Continuing Education office at RUSH to ensure that its CE activities are independent, free of commercial bias. Therefore, we manage all financial relationships associated with accredited continuing education activities. RUSH asks everyone who has the ability to control or influence the content of an educational activity to disclose information about all of their financial relationships with ineligible companies within the prior 24 months. An ineligible company is an entity whose primary business is producing, marketing, selling, re-selling or distributing healthcare products used by or on patients. There is no minimum threshold; individuals must disclose all financial relationships, regardless of the amount, with ineligible companies. Individuals must disclose regardless of their view of the relevance of relationships to education. Mechanisms are in place to identify and mitigate any potential conflicts of interest prior to the planning, implementation, or evaluation of the continuing education activity. If a financial relationship is identified for the person in control of content, conflict mitigation strategies will be used to mitigate the financial relationship before they assume their role.
Individuals in control of content for this activity have the following relevant financial relationships with ineligible companies to disclose and all financial relationships have been mitigated.
The following financial relationships have been provided:
Gary W. Falk, MD, MS
Sources of Funding for Research: Allakos, Celgene/Bristol Myers Squibb, Ellodi, Takeda
Consulting Agreements: Ellodi, Phathom, Regeneron/Celgene, Takeda, Ubiquity
Katherine Alexander, MHS, PA-C
No financial relationships to disclose.
Alexis Munoz, BSN
No financial relationships to disclose.
Rush University Medical Center and the Office of Interprofessional Continuing Education staff members, ACHL staff members, and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.
The content for this activity was developed independently of any ineligible company. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor(s).
This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.
This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. Rush University Medical Center and ACHL require the speaker to disclose that a product is not labeled for the use under discussion.
Discussion of Off-Label, Investigational, or Experimental Drug/Device Use: proton pump inhibitors, fluticasone (APT-1011), mometasone (ESO-101), barzovolimab, cendakimab, lirentelimab, tezepelumab, etrasimod, and IRL201104 are not approved for the treatment of EoE.
Unapproved Uses of Drugs/Devices: In accordance with requirements of the FDA, the audience is advised that information presented in this continuing medical education activity may contain references to unlabeled or unapproved uses of drugs or devices. Please refer to the FDA approved package insert for each drug/device for full prescribing/utilization information.
This activity will take approximately 75 minutes to complete. To receive credit, learners are required to complete the pretest, view the online activity, and complete the posttest and evaluation. To receive credit, 75% must be achieved on the posttest. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.
Rush University Medical Center designates this Enduring Material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.
Rush University Medical Center designates this Enduring Material for a maximum of 1.25 nursing contact hour(s).
