Anti–IL-5 (mepolizumab) therapy for eosinophilic esophagitis

Anti–IL-5 (mepolizumab) therapy reduces eosinophil activation ex vivo and increases IL-5 and IL-5 receptor levels

“…18,20 Subject characteristics-Of the 25 subjects enrolled, 18 were diagnosed with a diverse set of HESs, as defined by a recent workshop (Table I). 22 Six subjects were diagnosed with EE.…”

“…Of these subjects, 4 subjects with EE and 3 subjects with HES had participated in a previous study that evaluated peripheral blood and tissue eosinophil counts in response to anti-IL-5 therapy, but they were not evaluated for immunologic changes. 18,20 One other subject was diagnosed with EGID only. No study subject had previously received mepolizumab; in total, there were 7 overlap subjects within other mepolizumab clinical trials.…”

“…Peripheral blood eosinophil counts were measured as previously reported. 20 Response to therapy was defined as a statistically significant reduction in peripheral blood eosinophil counts. RT-PCR for detection of FIP1L1-PDGFRA fusion gene was performed by using methods previously reported.…”

“…Preliminary data in patients with HES and EE treated with anti-IL-5 have revealed promising results, including improvements in clinical parameters and levels of tissue eosinophilia. [17][18][19][20] The first randomized, double-blind, placebo-controlled trial of patients with HES was recently conducted and aimed at demonstrating the ability of anti-IL-5 to decrease prednisone dependence in HES not associated with the constitutively activated tyrosine kinase FIP1L1-platelet-derived growth factor receptor α (FIP1L1-PDGFRA). 21 Impressively, this international trial revealed a striking ability of anti-IL-5 to decrease prednisone doses, decrease blood eosinophilia, and maintain clinical stability compared with placebo.…”

The Impact of Therapeutic Antibodies on the Management of Digestive Diseases: History, Current Practice, and Future Directions

“…Although the monoclonal antibody against IL-5, mepolizumab is approved for asthma with an eosinophilic phenotype, and studies have considered its use for eosinophilic esophagitis [111]. Limited studies demonstrate that mepolizumab reduces intraepithelial eosinophils in children and adults, though efficacy with reducing symptoms is lacking [112,113].…”