Eosinophil-Driven Diseases (EDDs)
Our ambition to address unmet needs for people with EDDs
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Our commitment to eosinophil-driven diseases
Building on a 50-year heritage in respiratory care and following the science of common pathways and underlying disease drivers from respiratory disease into immunology-driven disease areas, we’re continuing to better understand the important role of eosinophils as key effector cells in a range of potentially devasting inflammatory diseases, also known as eosinophil-driven diseases (EDDs).
EDDs are inflammatory illnesses in which elevated eosinophils are a direct cause or are thought to play a critical role.1 Some EDDs have limited or no approved treatment options, creating a significant unmet need for innovative medicines. We know now that a process called eosinophilic immune dysfunction may be responsible for the eosinophil recruitment and activation that is driving these diseases. Backed by a growing body of evidence, we’re committed to advancing the understanding of the role of eosinophils in inflammatory diseases across Respiratory & Immunology, with the aim to improve diagnosis, patient referrals and timely, appropriate treatment.
Patient Portraits
Greg
– Living with Eosinophilic Esophagitis (EoE)
“It was pretty terrifying to not be able to go out and eat and take my wife anywhere without worrying about getting home...or having severe abdominal pain so bad that it just made you bend over in a ball.”
Ginger
– Living with Eosinophilic Granulomatosis with Polyangiitis (EGPA)
“Before this, I was a career person and I exercised a lot and now I can’t do any of that anymore. Your friends kind of disappear when you get sick because nobody wants to sit on your couch constantly and watch movies, but that’s pretty much what you can do. It’s hard for you to get up and do things."
Types of eosinophil-driven diseases
We are currently investigating potential medicines to treat inflammatory, EDDs where unmet medical need remains significant and, in some cases, where we see an increasing prevalence.
Atopic Dermatitis (AD)
Also known as eczema, AD is a chronic disease that causes the skin to become inflamed and irritated, which for many patients can be painful and lead to emotional stress and infections. Half of patients with moderate to severe eczema also suffer from asthma, hay fever (allergic rhinitis), and food allergies.[2,3]
Bullous Pemphigoid (BP)
BP is a rare, autoimmune, chronic skin disorder characterised by blistering, urticarial lesions (hives) and itching. The disorder typically occurs in elderly patients with an average patient age of 80 years.[2,4]
Chronic Obstructive Pulmonary Disease (COPD)
COPD is a progressive disease which can cause obstruction of airflow in the lungs resulting in debilitating bouts of breathlessness.[5] It affects an estimated 384 million people worldwide[6] and is predicted to be the third leading cause of death by 2020.[7] Improving lung function, reducing exacerbations and managing daily symptoms such as breathlessness are important treatment goals in the management of COPD.[5]
Chronic rhinosinusitis with nasal polyps (CRSwNP)
CRSwNP is characterised by persistent inflammation of the lining of the nasal passages and sinuses accompanied by benign growths called nasal polyps.[23,24] In patients with CRSwNP, elevated levels of eosinophils accumulate in the upper respiratory tract.[25] Nasal polyps can block passages and lead to breathing problems, reduction in the sense of smell and nasal discharge.[26-28]
Chronic Spontaneous Urticaria (CSU)
CSU is a dermatological condition where hives, welts, or swelling under the skin form on the skin and last for more than six weeks.[2,8] Hives are itchy and can occur anywhere on the body including the face, extremities, chest, back or face.[2,8] Hives range in size from just a few millimetres to several centimetres.[2,8] CSU has a significant burden on patients’ quality of life including sleep impairments and overall functioning.[9]
Eosinophilic Asthma (EA)
Eosinophilic asthma is a common type of asthma characterised by high levels of eosinophils that can cause airway inflammation.[2,10-12]
Eosinophilic Oesophagitis (EoE)
A rare chronic, inflammatory disease of the oesophagus characterised by the accumulation of eosinophils in the oesophageal lining tissue, resulting in injury, fibrosis and dysfunction that can potentially lead to chronic pain, difficulty swallowing, poor growth, malnutrition and weight loss.[13]
Eosinophilic Gastritis/Eosinophilic Gastroenteritis (EG/EGE)
EG/EGE are rare, chronic, relapsing diseases characterised by inflammation of the stomach and/or small bowel, which result in debilitating symptoms such as abdominal pain, nausea, vomiting, satiety (feeling overfull), loss of appetite and diarrhoea.[14-17] EG/EGE symptoms are primarily related to eosinophilic inflammation, which causes tissue injury and remodelling of the stomach and small bowel lining.[18]
Eosinophilic Granulomatosis with Polyangiitis (EGPA)
A rare, chronic autoimmune disease that is caused by inflammation of small to medium-sized blood vessels, resulting in damage to multiple organs, including lungs, skin, heart, gastrointestinal tract and nerves.[19,20]
Hypereosinophilic Syndrome (HES)
A group of rare disorders characterised by high numbers of eosinophils in blood and tissues, which can cause progressive organ damage over time, and if left untreated, can be fatal.[21,22] HES most commonly impacts the skin, heart, lungs, gastrointestinal tract and central nervous system.[21]
Join us
At AstraZeneca, we’re driven by innovation and our commitment to make a real-life difference in patients’ lives. Join us and help deliver life-changing medicines. Be among our employees who continue to make us an innovation-driven company that stands firmly among the world’s leaders in biopharmaceuticals.
References
1. American Partnership for Eosinophilic Disorders. What is an eosinophil associated disease? Available at: https://apfed.org/about-ead/what-is-an-eosinophil-associated-disease/. [Last accessed: December 2020].
2. Ramirez GA, Yacoub MR, Ripa M, et al. Eosinophils from physiology to disease: a comprehensive review. Biomed Res Int. 2018; 9095275.
3. Silverberg JI. Comorbidities and the impact of atopic dermatitis. Ann Allergy Asthma Immunol. 2019;123 (2): 144-151
4. National Organisation for Rare Disorders. Bullous Pemphigoid. Available at: https://rarediseases.org/rare-diseases/bullous-pemphigoid. [Last accessed: December 2020].
5. GOLD. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020. [Online]. Available at: https://goldcopd.org/wp-content/uploads/2019/12/GOLD-2020-FINAL-ver1.2-03Dec19_WMV.pdf [Last accessed: December 2020].
6. Adeloye D, Chua S, Lee C, et al. Global Health Epidemiology Reference Group (GHERG). Global and regional estimates of COPD prevalence: Systematic review and meta-analysis. J Glob Health. 2015; 5 (2): 020415.
7. Quaderi SA, Hurst JR. The unmet global burden of COPD. Glob Health Epidemiol Genom. 2018; 3: e4.
8. American Academy of Allergy Asthma & Immunology. Hives (urticaria) and Angioedema overview Available at: https://www.aaaai.org/conditions-and-treatments/library/allergy-library/hives-angioedema. [Last accessed: December 2020].
9. Maurer M, Abuzakouk M, Bérard F, et al. The burden of chronic spontaneous urticaria is substantial: Real-world evidence from ASSURE-CSU. Allergy. 2017; 72: 2005–2016.
10. Wenzel SE. Severe asthma in adults. Am J Respir Crit Care Med. 2005; 172: 149-160.
11. Coumou H, Bel EH. Improving the diagnosis of eosinophilic asthma. Expert Rev Respir Med. 2016;10(10): 1093-1103.
12. Trivedi SG, Lloyd CM. Eosinophils in the pathogenesis of allergic airways disease. Cell Mol Life Sci. 2007; 64 (10): 1269-1289.
13. American Partnership for Eosinophilic Disorders. EoE. Available at: https://apfed.org/about-ead/egids/eoe. [Last accessed: December 2020].
14. Naramore S, Gupta SK. Non-esophageal eosinophilic gastrointestinal disorders: clinical care and future directions. J Pediatr Gastroenterol Nutr. 2018; 67: 318–21.
15. Zhang M, Li Y. Eosinophilic gastroenteritis: a state-of-the-art review: Eosinophilic gastroenteritis. J Gastroenterol Hepatol. 2017; 32: 64–72.
16. Walker MM, Potter M, Talley NJ. Eosinophilic gastroenteritis and other eosinophilic gut diseases distal to the oesophagus. Lancet Gastroenterol Hepatol. 2018; 3 (4): 271-280.
17. Bedell A, Taft T, Craven MR, et al. Impact on Health-Related Quality of Life in Adults with Eosinophilic Gastritis and Gastroenteritis: A Qualitative Assessment. Dig Dis Sci. 2018; 63 (5): 1148-1157.
18. Lucendo AJ, López-Sánchez P. Targeted Therapies for Eosinophilic Gastrointestinal Disorders. BioDrugs 2020; 34: 477–493
19. American Partnership for Eosinophilic Disorders. Eosinophilic Granulomatosis with Polyangiitis (EGPA). Available at: https: apfed.org/about-ead/eosinophilic-granulomatosis-with-polyangiitis/. [Last accessed: December 2020].
20. Baldini C, Talarico R, Della Rossa A, Bombardieri S. Clinical Manifestations and Treatment of Churg-Strauss Syndrome. Rheum Dis Clin N Am. 2010; 36: 527-543.
21. American Partnership for Eosinophilic Disorders. Hypereosinophilic Syndromes. Available at: https://apfed.org/about-ead/hypereosinophilic-syndrome/. [Last accessed: December 2020].
22. American Partnership for Eosinophilic Disorders. APFED Hypereosinophilic Syndromes Brochure. December 2017. Available at: http://apfed.org/wp-content/uploads/2017/12/APFED_HES_bro_final.pdf. [Last accessed: December 2020].
23. Bachert C, Akdis CA. Phenotypes and Emerging Endotypes of Chronic Rhinosinusitis. J Allergy Clin Immunol Pract. 2016; 4 (4): 621-628.
24. Newton JR, Ah-See KW. A review of nasal polyposis. Ther Clin Risk Manag. 2008; 4 (2): 507-512.
25. Fujieda S Imoto Y, Kato Y, et al. Eosinophilic chronic rhinosinusitis. Allergology Int. 2019; 68 (4): 403-412.
26. Hopkins C. Chronic Rhinosinusitis with Nasal Polyps. N Engl J Med. 2019; 381 (1): 55-63.
27. Stevens WW, Schleimer RP, Kern RC. Chronic Rhinosinusitis with Nasal Polyps. J Allergy Clin Immunol Pract. 2016; 4 (4): 565-572.
28. Abdalla S, Alreefy H, Hopkins C. Prevalence of sinonasal outcome test (SNOT-22) symptoms in patients undergoing surgery for chronic rhinosinusitis in the England and Wales National prospective audit. Clin Otolaryngol. 2012; 37 (4): 276-282.
Veeva ID: Z4-29652
Date of Prep: December 2020