Answering the Call

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SEEMA ACEVES, MD, PHD

Dr. Seema Aceves is a professor of pediatrics and medicine at UCSD and Director of the multidisciplinary Eosinophilic Gastrointestinal Disorders Clinic at Rady Children’s Hospital, San Diego. She completed her medical and graduate degrees, Pediatrics residency training, and Allergy and Immunology fellowship training in San Diego at UCSD and at the Salk Institute. Her lab studies the mechanisms of tissue remodeling in eosinophilic esophagitis (EoE) and has had several pivotal findings in EoE including the presence of remodeling in the EoE esophagus, the role of transforming growth factor-β in EoE remodeling, and the role of the rigid extracellular environment in changing esophageal structural cell function. She is the Principal Investigator on the lab’s eosinophilic gastrointestinal disease (EGID)–related clinical trials. In 2020, Dr. Aceves became the inaugural holder of the MRD Endowed Chair in Pediatrics. She has served as a reviewer for and on the editorial boards of top-ranking allergy and gastroenterology journals and is among the nation’s top doctors in the U.S. News & World Report “Top Doctors” List.

SANDRA CHRISTIANSEN, MD

Dr. Sandra Christiansen is a professor of medicine at UCSD and Director of Translational Research for the US HAEA Angioedema Center. A summa cum laude graduate of Stritch School of Medicine in Chicago, Illinois, she was honored with the Janet Glasgow outstanding student award in 1979. She trained in Internal Medicine at University of California Los Angeles and UCSD and in Allergy & Immunology at Scripps Clinic in San Diego. While at Scripps Clinic, Dr. Christiansen served as Division Chief and received the 1985 AAAAI Young Investigator, 1985 AAAAI President’s, 1991 Felton Foundation, and 1999 Skaggs Clinical Research Scholar awards. From 2000-2015, Dr. Christiansen was a member of the Allergy Department at Kaiser Permanente, where she was recognized with the 2008 Everyday Hero, 2009 Clinical Trials, 2013 Patient Satisfaction, and 2014 Physician Merit awards. She has been at UCSD since 2015. Elected to AAAAI Fellowship in 1992, she is cited among Best Doctors in America. Her clinical and research interests include angioedema, airway inflammation, and programs targeted at upgrading allergy and immunology care for underserved communities. Dr. Christiansen has authored over 100 publications in peer-reviewed journals such as The New England Journal of Medicine, Journal of Clinical Investigation, Journal of Allergy and Clinical Immunology, and American Academy of Pediatrics, and chapters in Middleton’s Allergy Principles and Practice and Goodman and Gilman’s: The Pharmacological Basis of Therapeutics. She has been recognized with the AAAAI 2008 Volunteer Clinical Faculty and 2022 Distinguished Clinician awards.

JOSHUA B. WECHSLER, MD, MS

Dr. Joshua Wechsler is a pediatric gastroenterologist physician-scientist at Ann & Robert H. Lurie Children’s Hospital of Chicago/Northwestern University Feinberg School of Medicine. Director of the Eosinophilic Gastrointestinal Diseases (EGIDs) Clinic, Dr. Wechsler also sees patients with EGIDs, and performs endoscopy. He oversees a translational research team committed to uncovering key mechanisms of mast cell activation in EGIDs. Dr. Wechsler’s key goals are to identify novel treatment targets, improve outcomes, reduce morbidity, and personalize care. His laboratory recently identified a subset of children with EoE for whom low eosinophil counts after treatment can yield elevated mast cells if they have persistent endoscopic abnormalities and symptoms. Dr. Wechsler’s laboratory studies mast cell activation in EoE using 3-D models of the mucosa, primary mast cell culture, tissue mast cell phenotyping, and single cell analysis of mast cell signaling. Dr. Wechsler is passionate about eosinophilic gastrointestinal diseases and advancing care through research.

Professor, Pediatrics and Medicine MRD Endowed Chair in Pediatrics Director, Eosinophilic Gastrointestinal Disorders Clinic, Division of Allergy Immunology Rady Children’s Hospital San Diego, University of California San Diego (UCSD) San Diego, California

Professor of Medicine Director of Translational Research US Hereditary Angioedema Association (HAEA) Angioedema Center at UCSD San Diego, California

Assistant Professor of Pediatrics (Gastroenterology, Hepatology, and Nutrition) and Medicine (Allergy and Immunology) Northwestern University Feinberg School of Medicine Attending Physician, Gastroenterology, Hepatology, and Nutrition Ann & Robert H. Lurie Children’s Hospital of Chicago Foundation Research Scholar Campaign Urging Research for Eosinophilic Disease (CURED) Chicago, Illinois


EVAN DELLON, MD, MPH

Dr. Evan Dellon is a professor of medicine and adjunct professor of epidemiology at the University of North Carolina (UNC) School of Medicine in Chapel Hill, North Carolina. Dr. Dellon received his undergraduate degree from Brown University in Providence, Rhode Island, and his medical degree from Johns Hopkins School of Medicine in Baltimore, Maryland. He completed his internship and residency in Internal Medicine at Massachusetts General Hospital in Boston, Massachusetts. He performed a clinical and a research fellowship in Adult Gastroenterology at UNC, during which he also earned a Master of Public Health in Epidemiology from the UNC School of Public Health. Dr. Dellon is currently the Director of the UNC CEDAS and serves as an Associate Editor for Clinical Gastroenterology and Hepatology. Dr. Dellon’s main research interest is in the epidemiology, pathogenesis, diagnosis, treatment, and outcomes of eosinophilic esophagitis (EoE) and the eosinophilic GI diseases (EGIDs). The goal of his research is to improve the lives of patients with EoE and EGIDs by learning how to better diagnose, treat, and monitor the conditions.

ROBERT M. GENTA, MD, AGAF, FACG

Robert M. Genta, MD, AGAF, FACG, is a gastrointestinal pathologist whose research is focused on the inflammatory diseases of the gastrointestinal tract. He is the Chief for Academic Affairs at Inform Diagnostics, Irving, Texas and an adjunct professor in the Departments of Pathology and Medicine (Gastroenterology) at Baylor College of Medicine in Houston, Texas. For the past decade, Dr. Genta has devoted much of his research efforts to patho-epidemiology, a novel discipline that uses large databases of clinical and histopathological data to detect and elucidate associations amongst gastrointestinal diseases. He has also focused his clinical activities and research on the histopathologic aspects of eosinophilic diseases of the gastrointestinal tract. Dr. Genta is a fellow of the American College of Gastroenterology. His research has been published in peer-reviewed journals including The New England Journal of Medicine and the American Journal of Gastroenterology.

TROYCE VENTURELLA, MPH, RN, CCM

Ms. Troyce Venturella is a Nurse Case Manager and Patient Advocate. She received an undergraduate degree from Barnes College of Nursing at Washington University in St. Louis, Missouri, and a Master of Public Health in Rare Patient Populations from Rollins College in Winter Park, Florida. As a person living with a rare disease, Ms. Venturella continues to look for ways to improve the quality of life of others living with rare diseases.

BRUCE L. ZURAW, MD

Dr. Bruce Zuraw is the US HAEA Endowed Professor of Medicine at the University of California San Diego and Chief of the Division of Rheumatology, Allergy, and Immunology. He is also Chief of Allergy at the San Diego Veterans Administration Healthcare System. Dr. Zuraw obtained his medical degree from the Loyola Stritch School of Medicine in Chicago, Illinois, and was a postdoctoral research fellow at the Scripps Clinic and Research Foundation in San Diego, where he also trained in Allergy and Immunology. He joined the faculty at The Scripps Research Institute, where he stayed until moving to UCSD in 2004. Dr. Zuraw’s research interests center on inflammatory lung disease and hereditary and bradykinin-mediated angioedema. He has published over 200 articles and received continuous research funding for over 30 years with grants from the National Institutes of Health (NIH), Department of Defense, and the Veterans Administration. Dr. Zuraw was deeply involved in the formation in the United States of both an investigator network and an angioedema patient advocacy organization. Dr. Zuraw is the Chair of the US HAEA Medical Advisory Board and Cochair of the HAE International scientific committee. He is the founder and Director of the US HAEA Angioedema Center at UCSD.

Professor, Department of Medicine Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina (UNC) at Chapel Hill Adjunct Professor of Epidemiology Director, Center for Gastrointestinal Biology and Disease (CGIBD) Biostatistics and Clinical Research Core Director, Center for Esophageal Diseases and Swallowing (CEDAS) Chapel Hill, North Carolina

Adjunct Professor of Pathology and Medicine (Gastroenterology) Baylor College of Medicine Houston, Texas Chief for Academic Affairs Inform Diagnostics Irving, Texas

HAE Health Advocate US HAEA Fairfax City, Virginia

Professor of Medicine, UCSD School of Medicine Director, US HAEA Angioedema Center UCSD Health San Diego, California


TARGET AUDIENCE The design of this program addresses the needs of allergists/clinical immunologists, gastroenterologists, and other clinicians involved in the identification and management of patients with eosinophilic esophagitis (EoE) or hereditary angioedema (HAE).

PROGRAM DESCRIPTION This live Call-a-Colleague™ educational program will guide conference attendees on the identification and management of patients with EoE or HAE. Expert faculty will discuss the pathogenesis, differential diagnosis, and multidisciplinary management of children and adults with these uncommon and difficult-to-treat conditions. Interspersed throughout the program are brief Call-a-Colleague video calls in which faculty consult with a pathologist, a dietitian, a pediatric gastroenterologist, the Chair of the US HAE Association, and a patient with HAE. The consultative calls will provide additional insights into the burdens, diagnosis, and current/emerging treatment of patients with these conditions.

LEARNING OBJECTIVES

and mitigated by Integritas in accordance with the Standards for Integrity and Independence in Accredited CE in advance of delivery of the activity to learners. The content of this activity was vetted by Integritas to assure objectivity and that the activity is free of commercial bias. All relevant financial relationships have been mitigated. The faculty have the following relevant financial relationships with ineligible companies: Seema Aceves, MD, PhD

Sandra Christiansen, MD Consulting Fee: Atheneum, Catabasis Pharmaceuticals, Cycle Pharmaceuticals, Takeda Pharmaceutical Company Limited Evan Dellon, MD, MPH

Consulting Fee: Abbott Laboratories, AbbVie, Adare Pharma Solutions/ Ellodi Pharmaceuticals, Aimmune Therapeutics, Allakos Inc., Amgen Inc., Arena Pharmaceuticals, Inc., AstraZeneca plc, Avir Pharma Inc., Biorasi, LLC, Calypso Biotech, Celgene Corporation/Receptos, Inc./ Bristol Myers Squibb, Celldex Therapeutics, Eli Lilly and Company, EsoCap Biotech, GlaxoSmithKline, Gossamer Bio, Invea Therapeutics, Landos Biopharma, Lucid Diagnostics, Morphic Therapeutic, Nutricia, Parexel International Corporation/Calyx, Phathom Pharmaceuticals, Regeneron Pharmaceuticals, Inc., Revolo Biotherapeutics, Robarts/ Alimentiv, Inc., Salix Pharmaceuticals, Sanofi S.A., Shire plc/Takeda Pharmaceutical Company Limited, Target RWE; Contracted Research: Adare Pharma Solutions /Ellodi Pharmaceuticals, Allakos Inc., Arena Pharmaceuticals, Inc., AstraZeneca plc, GlaxoSmithKline, Meritage Pharma, Miraca Life Sciences, Nutricia, Celgene Corporation/Receptos, Inc./Bristol Myers Squibb, Regeneron Pharmaceuticals, Inc., Shire plc/ Takeda Pharmaceutical Company Limited; Other (Educational Grant): Allakos Inc., Banner Life Sciences, Holoclara, Inc.

Robert M. Genta, MD, AGAF, FACG

Consulting Fee: Allakos Inc., Adare Pharma Solutions /Ellodi Pharmaceuticals

Upon completion of this activity, the participant should be better able to: • Describe the pathophysiologic mechanisms underlying EoE and HAE development, with a focus on the rationale for various therapies • Comprehensively assess pediatric and adult patients with suspected EoE or HAE to accelerate differential diagnoses • Discuss the clinical profiles and trial evidence for current and emerging treatment strategies for EoE or HAE • Longitudinally manage pediatric and adult patients with EoE or HAE based on symptoms, recent clinical guidelines, and therapeutic responses • Communicate with patients, caregivers, and members of the multidisciplinary team to ensure continuity of care and promote shared clinical decision-making

DISCLOSURE OF CONFLICTS OF INTEREST Integritas Communications (Integritas) adheres to the policies and guidelines, including the Standards for Integrity and Independence in Accredited CE, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous. All persons in a position to control the content of an accredited continuing education program provided by Integritas are required to disclose all financial relationships with any ineligible company within the past 24 months to Integritas. All financial relationships reported are identified as relevant

Consulting Fee: AstraZeneca plc, Regeneron Pharmaceuticals, Inc./ Sanofi S.A.; Contracted Research: NIH-NIAID, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Center for Advancing Translational Sciences (NCATS); Royalty: UCSD patent for oral viscous budesonide; Educational CME Speaker: Regeneron Pharmaceuticals, Inc./Sanofi S.A., WebMD/MedScape

Troyce Venturella, MPH, Nothing to disclose RN, CCM Joshua B. Wechsler, MD, MS

Consulting Fee: Allakos Inc., Regeneron Pharmaceuticals, Inc., Sanofi S.A.


Bruce L. Zuraw, MD

Consulting Fee: CSL Behring, Takeda Pharmaceutical Company Limited, Cycle Pharmaceuticals, BioMarin Pharmaceutical Inc.; Honoraria: Takeda Pharmaceutical Company Limited; Speakers Bureau: Medscape; Royalty: UpToDate, UCSD; Other: Inventor of the Threshold-Stimulated Kallikrein Activity (TSKA) assay; patent held by UCSD

The Integritas planners and managers have reported no relevant financial relationships with ineligible companies.

INTEGRITAS COMMUNICATIONS CONTACT INFORMATION For questions about this activity, please contact Integritas Communications at info@exchangecme.com.

This program is not sponsored or programmed by the AAAAI. This activity is provided by Integritas Communications and supported by an independent educational grant from Takeda Pharmaceutical Company Limited.


PROGRAM AGENDA 6:00 pm

Dinner/Registration

6:30 pm

Faculty Introductions and Preactivity Survey

6:40 pm

An Overview of EoE

6:50 pm

Diagnosis and Evaluation of EoE Call-a-Colleague: Robert M. Genta, MD, AGAF, FACG (Pathologist)

7:05 pm

Long-term Multidisciplinary Management of EoE Biologics Call-a-Colleague: Evan Dellon, MD, MPH (EoE Investigator & Specialist)

7:30 pm

An Overview of HAE Call-a-Colleague: Troyce Venturella, MPH, RN, CCM (Patient Testimonial)

7:40 pm

Diagnosis and Evaluation of HAE

7:50 pm

Best Practices in the Management of HAE Call-a-Colleague: Bruce L. Zuraw, MD (HAE Investigator & Specialist)

8:15 pm

Postactivity Survey/Faculty Q&A Session

















EOSINOPHILIC ESOPHAGITIS GUIDELINES Updated international consensus diagnostic criteria for eosinophilic esophagitis: proceedings of the AGREE conference. Dellon ES, et al. Gastroenterol. 2018;155(4):1022-1033.e10 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174113/

AGA Institute and the Joint Task Force on Allergy-Immunology Practice Parameters Clinical Guidelines for the Management of Eosinophilic Esophagitis. Hirano I, et al. Gastroenterology. 2020;158(6):1776-1786. https://pubmed.ncbi.nlm.nih.gov/32359562/

Technical review on the management of eosinophilic esophagitis: a report from the AGA institute and the joint task force on allergy-immunology practice parameters. Rank MA, et al. Ann Allergy Asthma Immunol. 2020;124(5):424-440.e17 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8171057/

PATIENT RESOURCES American Partnership for Eosinophilic Disorders (Apfed). https://apfed.org/

Campaign Urging Research for Eosinophilic Disease (CURED) http://curedfoundation.org/

National Organization for Rare Disorders. https://rarediseases.org/rare-diseases/eosinophilic-esophagitis/

SUGGESTED READING One-hour esophageal string test: a nonendoscopic minimally invasive test that accurately detects disease activity in eosinophilic esophagitis. Ackerman SJ, et al. Am J Gastroenterol. 2019;114(10):1614-1625. https://pubmed.ncbi.nlm.nih.gov/31567192/

Phenotypic characterization of eosinophilic esophagitis in a large multicenter patient population from the Consortium for Food Allergy Research. Chehade M, et al. J Allergy Clin Immunol Pract. 2018;6(5):1534-1544.e5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132253/

Mechanisms of disease of eosinophilic esophagitis. Davis BP, Rothenberg ME. Annu Rev Pathol. 2016;11:365-393. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918086/

A phase 3, randomized, 3-part study to investigate the efficacy and safety of dupilumab in adult and adolescent patients with eosinophilic esophagitis: results from part A. Dellon ES. American College Gastroenterology Conference. October 26, 2020. Abstract LB3. https://www.eventscribe.com/2020/ACG/fsPopup. asp?efp=RElCSUFHUk02NDI2&PresentationID=783291&rnd=0.6661928&mode=presinfo

Diagnosis and treatment of eosinophilic esophagitis. Gonsalves NP, Aceves SA. J Allergy Clin Immunol. 2020;145(1):1-7. https://www.jacionline.org/article/S0091-6749(19)31546-5/fulltext

Budesonide oral suspension improves outcomes in patients with eosinophilic esophagitis: results from a phase 3 trial. Hirano I, et al. Clin Gastroenterol Hepatol. 2022;20(3);525-534. https://www.cghjournal.org/action/showPdf?pii=S1542-3565%2821%2900456-0

Functional lumen imaging probe for the management of esophageal disorders: expert review from the clinical practice updates committee of the AGA Institute. Hirano I, et al. Clin Gastroenterol Hepatol. 2017;15(3):P325-334. https://www.cghjournal.org/article/S1542-3565(16)30987-9/fulltext

Type 2 inflammation in eosinophilic esophagitis: from pathophysiology to therapeutic targets. Racca F, et al. Front Physiol. 2021;12:815842. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8790151/pdf/fphys-12-815842.pdf


HEREDITARY ANGIOEDEMA GUIDELINES US HAEA Medical Advisory Board 2020 guidelines for the management of hereditary angioedema. Busse PJ, et al. J Allergy Clin Immunol Pract. 2021;9(1):132-50. https://pubmed.ncbi.nlm.nih.gov/32898710/

Threshold-stimulated kallikrein activity distinguishes bradykinin- from histamine-mediated angioedema. Lara-Marquez ML, et al. Clin Exp Allergy. 2018;48(11):1429–1438 https://pubmed.ncbi.nlm.nih.gov/29957871/

SGP120 and the contact system in hereditary angioedema: a diagnostic tool in HAE with normal C1 inhibitor. Larrauri B, et al. Molecular Immunol. 2020;119:27-34.

PATIENT & CLINICIAN RESOURCES

https://pubmed.ncbi.nlm.nih.gov/31955064/

US Hereditary Angioedema Association

The humanistic burden of hereditary angioedema: impact on health-related quality of life, productivity, and depression. Lumry WR, et al. Allergy Asthma Proc. 2010;31(5):407-414.

https://www.haea.org/

National Organization for Rare Disorders.

https://pubmed.ncbi.nlm.nih.gov/20929608/

https://rarediseases.org/rare-diseases/eosinophilic-esophagitis/

SUGGESTED READING Patient-reported burden of hereditary angioedema: findings from a patient survey in the United States. Banerji A, et al. Ann Allergy Asthma Immunol. 2020;124(6):600-607.

Lanadelumb demonstrates rapid and sustained prevention of hereditary angioedema attacks. Riedl MA, et al. Allergy.2020;75(11):2879-2887. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7689768/

https://pubmed.ncbi.nlm.nih.gov/32169514/

Ecallantide. Zuraw BL, et al. Nat. Rev Drug Disc. 2010;9:189-190.

Hereditary angioedema: new finding concerning symptoms, affected organs, and course. Bork K, et al. Am J Med. 2006;119:267-274.

https://www.nature.com/articles/nrd3125

https://pubmed.ncbi.nlm.nih.gov/16490473/

Hereditary angioedema with normal C1 inhibitor: four types and counting. Zuraw BL. J Allergy Clin Immunol. 2018;141(3):884-885. https://pubmed.ncbi.nlm.nih.gov/29410040/

Hereditary angioedema. Busse PJ, Christiansen SC. New Engl J Med. 2020;382(12):1136-1148. https://pubmed.ncbi.nlm.nih.gov/32187470/

Long-term safety and effectiveness of berotralstat for hereditary angioedema: the open-label APeX-S study. Farkas H, et al. Clin Transl Allergy. 2021;11(4):e12035. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8221587/.


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