The US eosinophilic esophagitis (EoE) market, valued at $156.7 million in 2020, is projected to grow at a compound annual growth rate (CAGR) of 25.7%, to reach $1.5 billion by 2030. However, despite this impressive growth rate, low diagnosis rates caused by limited disease awareness will continue to keep the diagnosis cases at a low rate, says GlobalData, a leading data and analytics company.

EoE is defined as a chronic, immune-mediated, atopic inflammatory condition of the esophagus, recognized over the past two decades. In EoE, eosinophils infiltrate the esophagus, contributing to tissue damage and chronic inflammation. The condition is diagnosed by histologic analysis of ≥15 eosinophils per high power field (eos/hpf) in one or more esophageal biopsy specimens and exclusion of pathologic gastrointestinal reflux disease (GERD). EoE symptoms are similar to GERD, which is why the two conditions were thought to be the same for so long. The key to diagnosing EoE is that patients with EoE do not improve with GERD medications.

GlobalData’s latest report, ‘Eosinophilic Esophagitis – Opportunity Assessment and Forecast to 2030’, reveals that the growth in this market will be driven by sales of high-priced biologics such as Sanofi/Regeneron’s Dupixent (dupilumab), Bristol Myers Squibb’s Cendakimab (RPC-4046), and AstraZeneca’s Fasenra (benralizumab). Dupixent is expected to become the market leader with $915.6M in sales in 2030.

Mandana Emamzadeh, PhD, Healthcare Analyst at GlobalData, comments: “A large number of symptomatic treatments are currently being used off-label with the most frequently used drug classes being proton pump inhibitors and corticosteroids.”

Eight out of 11 pipeline agents are first-in-class drugs introducing novel mechanisms of action to EoE, including interleukin inhibitors (IL-13, IL-4, and IL-5 receptor subunit alpha inhibitors), a mast cell stabilizer, sphingosine 1-phosphate receptor agonist, anti-inflammatory, desensitization immunotherapy (allergen), and lanthionine synthetase component c-like protein 2 agonist.

Emamzadeh concludes: “Primary research revealed that strict inclusion/exclusion criteria for enrolling patients in studies is the main challenge for the EoE clinical trials. Additionally, the greatest unmet needs within the EoE market are lack of data, more effective or curative therapies, increased awareness and education, and more options for the pediatric population. GlobalData expects that the unmet needs will not be addressed during the forecast period, and opportunity remains for developers in the EoE market.”