全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Dupilumab in Gastrointestinal Allergies beyond the Esophagus

DOI: 10.4236/mri.2025.142006, PP. 79-88

Keywords: Dupilumab, Eosinophilic Gastritis, Eosinophilic Duodenitis, Eosinophilic Colitis, IL-4 Receptor Antibody

Full-Text   Cite this paper   Add to My Lib

Abstract:

Eosinophilic gastrointestinal disorders (EGIDs) are a group of chronic inflammatory conditions characterized by eosinophil infiltration into the gastrointestinal (GI) tract, which includes eosinophilic esophagitis (EoE), eosinophilic gastritis (EoG), eosinophilic duodenitis (EoD), eosinophilic colitis, and other forms of non-EoE EGIDs. While EoE has been well-studied, other forms of eosinophilic gastrointestinal involvement remain rare and lack diagnostic criteria, and standardized treatment options. The recent approval of Dupilumab, an IL-4 receptor antagonist, for the treatment of EoE, has spurred interest in its potential efficacy for other eosinophilic conditions with similar histological findings. This systematic review explores the emerging role of Dupilumab in the treatment of non-EoE EGIDs, including eosinophilic gastritis, duodenitis, and colitis, by analyzing available case reports, case series, and clinical trials published from 2015 onward. A total of four studies met the inclusion criteria, involving 17 patients (13 adults and 4 children) who were treated with Dupilumab. The results from these studies suggest that Dupilumab treatment led to significant clinical improvement, including a reduction in abdominal pain, dysphagia, and iron deficiency anemia, with corresponding endoscopic and histologic remission as evidenced by a decrease in tissue eosinophilia. Additionally, patients showed improved tolerance to trigger foods and reduced reliance on steroids. The duration of treatment varied, with most patients receiving 300 mg of Dupilumab either weekly or biweekly for an average of 6 - 12 months. Despite promising results, the optimal dosing regimen, long-term efficacy, and safety profile of Dupilumab in non-EoE EGIDs require further investigation through larger clinical trials. The review also highlights the potential for Dupilumab to serve as an alternative to steroids, particularly for patients with steroid-resistant or dependent forms of EGID. In conclusion, Dupilumab offers a promising new therapeutic option for patients with eosinophilic gastrointestinal disorders, but further studies are essential to better define its role in the treatment of these rare and complex diseases.

References

[1]  Gonsalves, N. (2019) Eosinophilic Gastrointestinal Disorders. Clinical Reviews in Allergy & Immunology, 57, 272-285.
https://doi.org/10.1007/s12016-019-08732-1
[2]  Dellon, E.S., Peterson, K.A., Murray, J.A., Falk, G.W., Gonsalves, N., Chehade, M., et al. (2020) Anti-Siglec-8 Antibody for Eosinophilic Gastritis and Duodenitis. New England Journal of Medicine, 383, 1624-1634.
https://doi.org/10.1056/nejmoa2012047
[3]  Lucendo, A.J., Serrano‐Montalbán, B., Arias, Á., Redondo, O. and Tenias, J.M. (2015) Efficacy of Dietary Treatment for Inducing Disease Remission in Eosinophilic Gastroenteritis. Journal of Pediatric Gastroenterology and Nutrition, 61, 56-64.
https://doi.org/10.1097/mpg.0000000000000766
[4]  Visaggi, P., Ghisa, M., Barberio, B., Maniero, D., Greco, E., Savarino, V., et al. (2023) Treatment Trends for Eosinophilic Esophagitis and the Other Eosinophilic Gastrointestinal Diseases: Systematic Review of Clinical Trials. Digestive and Liver Disease, 55, 208-222.
https://doi.org/10.1016/j.dld.2022.05.004
[5]  Shoda, T., Collins, M.H., Rochman, M., et al. (2022) Evaluating Eosinophilic Colitis as a Unique Disease Using Colonic Molecular Profiles: A Multi-Site Study. Gastroenterology, 162, 1635-1649.
https://doi.org/10.1053/j.gastro.2022.01.022
[6]  Pesek, R.D., Reed, C.C., Muir, A.B., Fulkerson, P.C., Menard-Katcher, C., Falk, G.W., et al. (2019) Increasing Rates of Diagnosis, Substantial Co-Occurrence, and Variable Treatment Patterns of Eosinophilic Gastritis, Gastroenteritis, and Colitis Based on 10-Year Data across a Multicenter Consortium. American Journal of Gastroenterology, 114, 984-994.
https://doi.org/10.14309/ajg.0000000000000228
[7]  Caldwell, J.H., Tennenbaum, J.I. and Bronstein, H.A. (1975) Serum IgE in Eosinophilic Gastroenteritis—Response to Intestinal Challenge in Two Cases. New England Journal of Medicine, 292, 1388-1390.
https://doi.org/10.1056/nejm197506262922608
[8]  Sia, T., Bacchus, L., Tanaka, R., Khuda, R., Mallik, S. and Leung, J. (2024) Dupilumab Can Induce Remission of Eosinophilic Gastritis and Duodenitis: A Retrospective Case Series. Clinical and Translational Gastroenterology, 15, e00646.
https://doi.org/10.14309/ctg.0000000000000646
[9]  Patel, N., Goyal, A., Thaker, A., Troendle, D. and Parrish, C. (2022) A Case Series on the Use of Dupilumab for Treatment of Refractory Eosinophilic Gastrointestinal Disorders. Journal of Pediatric Gastroenterology and Nutrition, 75, 192-195.
https://doi.org/10.1097/MPG.0000000000003512
[10]  Tsuge, M., Shigehara, K., Uda, K., Kawano, S., Iwamuro, M., Saito, Y., Yashiro, M., Ikeda, M. and Tsukahara, H. (2023) Successful Use of Dupilumab for Egg-Induced Eosinophilic Gastroenteritis with Duodenal Ulcer: A Pediatric Case Report and Review of Literature. Allergy, Asthma & Clinical Immunology, 19, Article No. 103.
https://doi.org/10.1186/s13223-023-00859-3
[11]  Takeshige, T., Koyama, R., Motomura, H., Okajima, A., Nishioki, T., Watanabe, J., Yae, T., Kido, K. and Takahashi, K. (2024) Effective Use of Dupilumab for Eosinophilic Gastritis Concomitant with Severe Asthma. Allergy, Asthma & Clinical Immunology, 20, Article No. 68.
https://doi.org/10.1186/s13223-024-00940-5
[12]  Singh, B., Kaur, P., Bai, S., Ethakota, J., Ranjan, N. and Quereshi, A. (2024) S2254 Dupilumab and Non-EOE GI Disorders. American Journal of Gastroenterology, 119, S1609-S1609.
https://doi.org/10.14309/01.ajg.0001038384.07766.97
[13]  Sun, Y., Pan, D., Kang, K., Sun, M., Li, Y., Sang, L., et al. (2020) Eosinophilic Pancreatitis: A Review of the Pathophysiology, Diagnosis, and Treatment. Gastroenterology Report, 9, 115-124.
https://doi.org/10.1093/gastro/goaa087
[14]  Awadie, H., Khoury, J., Zohar, Y., Yaccob, A., Veitsman, E. and Saadi, T. (2019) Long-Term Follow-Up of Severe Eosinophilic Hepatitis: A Rare Presentation of Hypereosinophilic Syndrome. Rambam Maimonides Medical Journal, 10, e0020.
https://doi.org/10.5041/rmmj.10373
[15]  Fragulidis, G.P., Vezakis, A.I., Kontis, E.A., Pantiora, E.V., Stefanidis, G.G., Politi, A.N., et al. (2016) Eosinophilic Cholangitis—A Challenging Diagnosis of Benign Biliary Stricture: A Case Report. Medicine, 95, e2394.
https://doi.org/10.1097/md.0000000000002394

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133