A Case Series on the Use of Dupilumab for Treatment of Refractory Eosinophilic Gastrointestinal Disorders

J Pediatr Gastroenterol Nutr. 2022 Aug 1;75(2):192-195. doi: 10.1097/MPG.0000000000003512. Epub 2022 Jun 6.

Abstract

The incidence and prevalence of eosinophilic esophagitis (EoE), eosinophilic gastritis (EoG), eosinophilic enteritis (EoN), and eosinophilic colitis (EoC) are increasing ( 1 ). These conditions will inevitably become more widely recognized and better understood. There is currently no Food and Drug Administration (FDA)-approved treatment for EoE, but there are standard-of-care treatments that are well established and widely used. In contrast, there is a paucity of data regarding standard-of-care treatment for non-EoE eosinophilic gastrointestinal disorders (EGID). We identified 3 patients that all achieved clinical and histopathologic remission on dupilumab, a monoclonal antibody that blocks the downstream signaling of interleukin (IL)-4 and IL-13. These patients had extra-esophageal forms of EGID with two patients failing to achieve remission on standard-of-care therapies and one patient experiencing significant side effects on swallowed budesonide therapy. The reduction in mucosal eosinophilia in several GI tract segments in these 3 patients highlights a new potential clinical indication for dupilumab in the treatment of pediatric EGID patients.

MeSH terms

  • Antibodies, Monoclonal, Humanized
  • Child
  • Enteritis* / epidemiology
  • Eosinophilia
  • Eosinophilic Esophagitis* / therapy
  • Gastritis* / therapy
  • Humans

Substances

  • Antibodies, Monoclonal, Humanized
  • dupilumab

Supplementary concepts

  • Eosinophilic enteropathy