Ilora Naik, MD1, Anila Vasireddy, MD2, Nicha Wongjarupong, MD1, Lim Jane, MD1, Yin Chan, MD3, Bianca Chang, MD3, Mark Pimentel, MD, FACG1, Ali Rezaie, MD, MSc1, Apoorva K. Chandar, MBBS, MPH4, Amrit K. Kamboj, MD1 1Cedars-Sinai Medical Center, Los Angeles, CA; 2University of Pennsylvania Health System, Philadelphia, PA; 3Cedars-Sinai Medical Center, Beverly Hills, CA; 4Digestive Health Institute, University Hospitals Cleveland Medical Center, Cleveland, OH Introduction: Eosinophilic esophagitis (EoE) is a chronic immune-mediated disorder characterized by eosinophilic infiltration and inflammation of the esophagus. While recent studies have demonstrated increasing incidence and prevalence of EoE, these have largely utilized data from individual centers or administrative databases in variable patient populations. The study aim was to examine epidemiological trends in EoE using a large, population-based database. Methods: This retrospective cohort study included patients with EoE in TriNetX, a national database encompassing 66 healthcare organizations, between January 2014 and December 2024. Inclusion criteria required patients to have a CPT code (43235, 43239, 43247-43249) for esophagogastroduodenoscopy (EGD) prior to EoE diagnosis which was defined using ICD-10 codes (K20.0). Data was collected on patient age, sex, race, and ethnicity, as well as atopic conditions. Negative binomial regression was used to evaluate trends. Results: A total of 87,359 patients were diagnosed with EoE between 2014-2024 (age 39 ± 21 years, 59% men, 79% White). The incidence of EoE increased from 0.15% in 2014 to 0.60% in 2024 (Figure 1A) and the prevalence increased from 0.55% to 3.24% during the study period (Figure 1B). The increase in EoE incidence between 2014-2024 was seen across different subgroups including by sex (men, 0.24% to 0.93%; women, 0.10% to 0.42%) (Figure 2A), age (18-49 years, 0.33% to 1%; ≥50 years, 0.08% to 0.27%) (Figure 2B), race (White, 0.18% to 0.67%; Black, 0.09% to 0.37%; Asian, 0.05% to 0.32%) (Figure 2C), and ethnicity (Hispanic or Latino 0.07% to 0.50%; Non-Hispanic or Latino, 0.16% to 0.62%). The incidence of atopic conditions also increased during the study period (asthma, 1.7% to 1.9%; eczema, 0.14% to 0.31%; and food allergies, 0.14% to 0.42%) (Figure 2D). Discussion: This large national, population-based study highlights a 4-fold increase in incidence and 6-fold increase in prevalence of EoE between 2014-2024 utilizing data from the TriNetX database. The increasing incidence in EoE was also observed across different subgroups including by age, sex, race, and ethnicity, and paralleled an increase in incidence of other atopic conditions during the study period. While this increase in EoE incidence may be, in part, due to increasing awareness of EoE and more frequently taken esophageal biopsies, further studies are needed to better elucidate factors contributing to the increasing incidence.
Figure: Figure 1. A) Incidence and B) Prevalence of EoE in the TriNetX database from 2014 to 2024.
Figure: Figure 2. Incidence of EoE in TriNetX between 2014-2024 stratified by A) sex B) age, and C) race. D) Incidence of atopic conditions in TriNetX between 2014-2024.
Disclosures: Ilora Naik indicated no relevant financial relationships. Anila Vasireddy indicated no relevant financial relationships. Nicha Wongjarupong indicated no relevant financial relationships. Lim Jane indicated no relevant financial relationships. Yin Chan indicated no relevant financial relationships. Bianca Chang indicated no relevant financial relationships. Mark Pimentel: Ardelyx – Consultant. Gemelli Biotech – Advisory Committee/Board Member, Royalties, Stock-privately held company. GoodLFE – Stock-privately held company. Salvo Health, Cylinder Health – Stock Options. Ali Rezaie: Ardelyx, Blueprint Medicine and Salix Pharmaceuticals – Consultant. Gemelli Biotech, and Good LFE – Equity stake. Apoorva Chandar indicated no relevant financial relationships. Amrit Kamboj: Sanofi – Speakers Bureau.
Ilora Naik, MD1, Anila Vasireddy, MD2, Nicha Wongjarupong, MD1, Lim Jane, MD1, Yin Chan, MD3, Bianca Chang, MD3, Mark Pimentel, MD, FACG1, Ali Rezaie, MD, MSc1, Apoorva K. Chandar, MBBS, MPH4, Amrit K. Kamboj, MD1. P2813 - Increasing Incidence of Eosinophilic Esophagitis in the United States Between 2014-2024: A TriNetX Study, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
