A once-weekly dose of the monoclonal antibody dupilumab led to symptomatic relief and tissue improvement in young adults and adolescents with eosinophilic esophagitis (EoE), according to a new study published in . New England Journal of MedicineThe study analyzed data from two Phase 3 clinical trials and involved an international group of researchers, including researchers from the Children’s Hospital of Philadelphia (CHOP).
EoE is a chronic food allergy that affects the esophagus, the tube that connects the mouth to the stomach. Caused by certain foods, this disease is caused by the accumulation of eosinophils, a type of white blood cell, in the esophagus, causing pain and damage. If untreated, the connective tissue in the esophagus can harden, scarring and narrowing the esophagus, as well as causing other medical complications such as food blockage and choking.
Current treatments for EoE include a food elimination diet, proton pump inhibitors (PPIs), swallowed topical glucocorticoids, and in some cases esophageal dilatation. However, her 30-40% of patients may not respond to first-line therapy, and some treatments have unwanted side effects.
Given the growing evidence suggesting that type 2 cytokines play a key role in EoE, researchers investigated using dupilumab to treat the condition. Dupilumab is a monoclonal antibody that blocks the shared receptor components of interleukin-4 and interleukin-13, two cytokines that are important and central drivers of type 2 inflammation.
Dupilumab is approved for the treatment of several type 2 inflammatory diseases, including atopic dermatitis, asthma, and EoE, and a phase 2 trial in adults with active EoE has shown that 300 mg weekly dupilumab was shown to reduce symptoms and improve esophageal tissue.
In the Phase 3 trial described in this study, investigators evaluated the efficacy and safety of dupilumab in patients aged 12 years and older when administered weekly or every 2 weeks compared to placebo. They found that weekly subcutaneous dupilumab 300 mg reduced symptoms and improved histologic outcomes, whereas biweekly dosing improved histologic outcomes but not symptoms. rice field.
“The results of this phase 3 trial offer hope to patients and families who have historically had limited options to treat EoE,” said study co-author and director of the Allergy Program at Children’s Hospital of Philadelphia. says Jonathan Spargel, MD. Pediatric Stuart E Starr chair. “This study shows that dupilumab is an excellent treatment option for patients with EoE, not only reducing symptoms but also targeting the underlying cause of the disease.”
Evan S. Dellon et al., Dupilumab in adults and adolescents with eosinophilic esophagitis. New England Journal of Medicine (2022). DOI: 10.1056/NEJMoa2205982
Courtesy of Philadelphia Children’s Hospital
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