As Easy as EoE: A Novel and Effective Multidisciplinary Approach to Care of Patients with Eosinophilic Esophagitis in the Age of Biologics

Chawla, Karan; Alabbas, Bedoor; Sheth, Dipa; Papademetriou, Marianna

doi:10.1007/s10620-020-06366-4

Cited by 5 publications

(6 citation statements)

References 52 publications

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“…73 All of these interleukins have been shown to be overrepresented in the tissues of EoE. 74 In other eosinophilic gastrointestinal pathologies, a role of IL-4 and IL-13 has also been reported. Together with eotaxin-3 and chemoattractant receptor expressed on Th2 cells (CRTH2), IL-4 and IL-13 may be involved in the abnormal activation of the eosinophilic system.…”

Section: Med Iator S Involved In Food Allergymentioning

confidence: 99%

“…In its It is therefore not surprising that drugs used for food allergy have also been tested for this condition. Biologics targeted towards IgE and IL‐5, also involved in the development of food allergy, 74 have been evaluated 145 . Among them: Omalizumab has only been shown to be effective in a small portion of EoE patients, namely those with less intense eosinophilia 146 …”

Section: Monoclonal Antibodies Showing Promise In Clinical Trials For Food Allergy‐related Conditionsmentioning

confidence: 99%

“…143,144 In its It is therefore not surprising that drugs used for food allergy have also been tested for this condition. Biologics targeted towards IgE and IL-5, also involved in the development of food allergy, 74 have been evaluated. 145 Among them:…”

Section: Eoementioning

confidence: 99%

“…In the development of eosinophils, in their activation and in their circulation, IL‐5 plays a fundamental role 73 . All of these interleukins have been shown to be overrepresented in the tissues of EoE 74 …”

Section: Mediators Involved In Food Allergymentioning

confidence: 99%

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The use of biologics in food allergy

Fiocchi

Vickery

Wood

2021

Clin Experimental Allergy

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Background Food allergy continues to pose problems due to its increased frequency and its increasingly high severity. In this context, alongside the traditional avoidance strategies of allergenic foods and desensitization through the cautious progression of exposure to foods in the context of oral immunotherapy (OIT), alternative strategies have made their way in the last decades. We review the possibilities of intervention in food allergy with the use of biological drugs capable of interfering with the synthesis of IgE, with their mechanisms of action, or with complex biological mechanisms that lead to the establishment of a food allergy. Methods Repeated Entrez PubMed searches using the template algorithm “Food allergy” and “biologics” or “Omalizumab” or “Dupilumab” or “milk desensitization” or “oral tolerance induction” or “oral immunotherapy” or “Etokimab” or “Tezepelumab” or “Quilizumab” or “Ligelizumab” or “Tralokinumab” or “Nemolizumab” or “Mepolizumab” or “Reslizumab” or “Benralizumab”. The authors’ clinical experience in paediatric allergy units of University hospitals was also drawn upon. Results The landscape in this context has changed dramatically over the past 10 years. We have acquired knowledge mainly on the effect of different types of anti‐IgE treatments in poliallergic patients with food allergy, and in patients treated with OIT. However, other mediators are being targeted by specific biologic treatments. Among them, the alarmins Il‐33 and TSLP, IL‐4 and IL‐13, eosinophil‐related molecules as IL‐6, IL‐8, IL‐10, IL‐12, and mostly IL‐5, and integrins involved in the pathogenesis of eosinophilic gastrointestinal diseases (EGIDs), as SIGLEC‐8. Conclusions The ever‐better knowledge of the mechanisms of food allergy allowing these developments will improve not only the perspective of patients with the most serious immediate food allergies such as anaphylaxis, but also those of patients with related diseases such as atopic dermatitis, eosinophilic esophagitis, and EGIDs. Biologics are also intended to complement OIT strategies that have developed over the years.

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Section: Med Iator S Involved In Food Allergymentioning

confidence: 99%

Section: Monoclonal Antibodies Showing Promise In Clinical Trials For Food Allergy‐related Conditionsmentioning

confidence: 99%

Section: Eoementioning

confidence: 99%

Section: Mediators Involved In Food Allergymentioning

confidence: 99%

See 2 more Smart Citations

The use of biologics in food allergy

Fiocchi

Vickery

Wood

2021

Clin Experimental Allergy

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“…The first documents the case of a 9-year-old male with EoE with up to 25 eosinophils per high-powered field (eos/hpf) at initial diagnosis, AD, and asthma, who demonstrated symptomatic and histologic improvement in EoE in addition to asthma and AD while on dupilumab ( 7 ). The second is a case of 42-year-old male with EoE, asthma, chronic urticaria, allergic rhinitis, and AD who was reported to remain in clinical and histologic remission on dupilumab after weaning off STC ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Real World Experience With Dupilumab in Eosinophilic Esophagitis in Children and Young Adults at a Tertiary Care Pediatric Medical Center

Syverson¹,

Rubinstein²

2022

JPGN Reports

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Dupilumab is one of a number of biologics currently under investigation for the treatment of eosinophilic esophagitis (EoE). We report on a group of 7 pediatric and young adult patients with EoE who were treated with dupilumab for a primary indication of asthma or atopic dermatitis, all of whom previously failed swallowed topical corticosteroid therapy dietary for management of their EoE. All 7 patients demonstrated histologic improvement in their EoE while on dupilumab, with a drop in median peak esophageal eosinophil count from 50 eosinophils per high-powered field (eos/hpf) (IQR 48-95 eos/hpf) to 2 eos/hpf (IQR 0-5 eos/hpf) off swallowed topical corticosteroid. Additionally, improvements in EoE symptoms and endoscopic findings were noted. This report highlights the effectiveness of dupilumab in a group of multiply atopic pediatric and young adult patients with difficult-totreat EoE in real world practice.

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Biologics in eosinophilic esophagitis

Zhang

Assa’ad

2021

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of reviewEosinophilic esophagitis (EoE) is a chronic inflammatory disease of the oesophagus whose incidence is on the rise. Despite maximal use of guideline-based therapies including food elimination diets and steroids, many patients remain symptomatic. This review serves to summarize safety and efficacy of monoclonal antibodies in treatment of EoE. Recent findingsThere has been an increasing number of biologics under consideration for EoE and several that have undergone clinical trials. mAbs that target specific effectors involved in the disease may offer additional clinical and histologic benefit. In addition, they offer a more benign adverse effect profile than traditional therapies.

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As Easy as EoE: A Novel and Effective Multidisciplinary Approach to Care of Patients with Eosinophilic Esophagitis in the Age of Biologics

Cited by 5 publications

References 52 publications

The use of biologics in food allergy

The use of biologics in food allergy

Real World Experience With Dupilumab in Eosinophilic Esophagitis in Children and Young Adults at a Tertiary Care Pediatric Medical Center

Biologics in eosinophilic esophagitis

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