Spherix Global Insights

December 05, 2022

With Approximately 45% of Eosinophilic Esophagitis Patients Going Undiagnosed, the Growth Opportunity for Sanofi/Regeneron’s Dupixent and Future Advanced Therapies Could Be Significant, According to Spherix

Surveyed US gastroenterologists and allergists agree a high unmet need remains, though treatment approach differs between groups

EXTON, Pa., December 5, 2022 /PRNewswire/ – Sanofi/Regeneron significantly changed the EoE treatment landscape last May when the FDA approved Dupixent (dupilumab) to treat adult and pediatric patients suffering from eosinophilic esophagitis (EoE). Spherix Global Insights’ recent research via their Market Dynamix™ EoE service suggests dupilumab’s first mover advantage may yield greater dividends when taking into account physician experience managing the disease.

The majority of physicians surveyed (n=104 gastroenterologists and 21 allergists) state EoE patients need to be diagnosed earlier in their disease journey and highlighted an average of 45% of EoE patients never receive a confirmed diagnosis.

While both gastroenterologists and allergists express satisfaction with Dupixent, their interest in more advanced options remains high, primarily driven by the common failures in first- and second-line treatment. These failures are most often caused by lack of efficacy or disease altering impact.

Although gastroenterologists and allergists agree the need for more advanced treatments is high, they differ quite significantly in both preference for new treatments and belief about how biologic agents should be integrated into clinical practice. When asked about the appropriate placement of biologics in the treatment pathway, allergists feel strongly about earlier introduction versus their gastro counterparts.

One surveyed allergist comments, “I’ve had professional level arguments with [gastroenterologists] about that… Essentially there is, I think, sometimes a little bit of a disconnect or divide about how much symptoms is enough [to prescribe a biologic].”

Data suggests that both specialties pursue the same primary clinical outcome of improving patients’ ability to swallow (reduced dysphagia) using different means. When questioned about future treatments, gastroenterologists leaned toward improved steroid options, while allergists see biologics as the better option to change the course of the disease.

An alignment of beliefs across both specialties and agreement on placement of biologics in the treatment pathway could further expand the number of eligible EoE patients receiving advanced disease modifying therapies in the future. Surmounting access and affordability barriers for advanced medication is cited by both specialties as key to helping patients achieve the best clinical outcome.

AstraZeneca’s failed MESSINA trial, evaluating Fasenra (benralizumab) for treatment of EoE, highlighted a difficulty in treating the disease.  While the trial achieved one co-primary endpoint – histologic reduction of eosinophils – it failed to show a clinical improvement in patient swallowing symptoms.

Physicians interviewed by Spherix speculated the dichotomy of outcomes may be a consequence of the multi-pathway disease characteristic of EoE and/or the potential need to treat EoE patients earlier in their journey with disease modifying agents.

In spite of the AstraZeneca setback, physicians’ expectations for BMS’s cendakimab and Ellodi Pharmaceuticals’ APT-1011 remain cautiously optimistic. Expectations for Allakos’ lirentelimab were slightly lower, possibly reflecting challenges their KRYPTOS trial experienced similar to AstraZeneca’s MESSINA – reducing eosinophils but failing to improve swallowing symptoms.


About Market Dynamix™
Market Dynamix™ is an independent service that explores future dynamics of evolving healthcare markets within specific indications where a paradigm shift is expected in the next 3 to 5 years.

About Spherix Global Insights
Spherix Global Insights is a leading provider of market intelligence and advisory services to the global life sciences industry.

The company’s unique service offerings are powered by deep therapeutic knowledge, the Spherix Network specialty physician panel, and commercially relevant analyses to enable strategic decision-making by our valued customers.

A trusted advisor and industry thought leader, Spherix Global Insights provides specialized market expertise in six (6) focused therapeutic areas including: dermatology, gastroenterology, nephrology, neurology, rheumatology, and ophthalmology.

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