Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024;16(13):845-852.
doi: 10.1080/1750743X.2024.2377060. Epub 2024 Jul 29.

The role of dupilumab in the treatment of eosinophilic esophagitis

Erin P Syverson  1 , Eitan Rubinstein  1 , John J Lee  2 , Douglas R McDonald  2 , Elizabeth Hait  1
Affiliations
Review

The role of dupilumab in the treatment of eosinophilic esophagitis

Erin P Syverson et al. Immunotherapy. 2024.

Abstract

Dupilumab has been approved to treat a variety of atopic disorders and was the first US FDA-approved medication for the treatment of eosinophilic esophagitis (EoE), initially approved in May 2022, with expansion in use to patients as young as 1 year of age weighing at least 15 kg in January 2024. It is a fully human monoclonal antibody that inhibits both IL-4 and IL-13 signaling, suppressing TH2-mediated proinflammatory cytokines, chemokines and IgE implicated in EoE pathogenesis. Phase II and III trials in EoE have demonstrated histologic, endoscopic and symptomatic improvement in disease activity with an overall favorable safety profile. This article will review the available clinical trial data and real-world efficacy of dupilumab in EoE.

Keywords: IL-13; IL-4; TH2; biologics; dupilumab; eosinophilic esophagitis.

Plain language summary

Dupilumab is a biologic medication used for the treatment of eosinophilic esophagitis. Clinical trials have shown that this medication is effective in treating both inflammation in the esophagus and symptoms associated with eosinophilic esophagitis in a high proportion of patients. Dupilumab was well tolerated by the majority of clinical trial patients, though side effects such as injection site redness and swelling have been reported. More serious side effects are overall rare.

PubMed Disclaimer

Conflict of interest statement

The author’s institution is a study site for phase 3 trials entitled “A randomized, double-blind, placebo-controlled study to investigate the efficacy and safety of dupilumab in pediatric patients with active eosinophilic esophagitis” sponsored by Sanofi and Regeneron Pharmaceuticals. EP Syverson acted as a consultant on a medical advisory board sponsored by Sanofi. The authors have no other competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript apart from those disclosed.

References

    1. Mansoor E, Cooper GS. The 2010–2015 prevalence of eosinophilic esophagitis in the USA: a population-based study. Dig Dis Sci. 2016;61(10):2928–2934. doi: 10.1007/s10620-016-4204-4 - DOI - PMC - PubMed
    1. Davis BP, Rothenberg ME. Mechanisms of disease of eosinophilic esophagitis. Annual Rev Pathology: Mechanisms Dis. 2016;11(1):365–393. doi: 10.1146/annurev-pathol-012615-044241 - DOI - PMC - PubMed
    1. Dellon ES, Hirano I. Epidemiology and natural history of eosinophilic esophagitis. Gastroenterology. 2018;154(2):319–32.e3. doi: 10.1053/j.gastro.2017.06.067 - DOI - PMC - PubMed
    1. Arias A, Gonzalez-Cervera J, Tenias JM, et al. Efficacy of dietary interventions for inducing histologic remission in patients with eosinophilic esophagitis: a systematic review and meta-analysis. Gastroenterology. 2014;146(7):1639–1648. doi: 10.1053/j.gastro.2014.02.006 - DOI - PubMed
    1. Lucendo AJ, Arias A, Molina-Infante J. Efficacy of proton pump inhibitor drugs for inducing clinical and histologic remission in patients with symptomatic esophageal eosinophilia: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2016;14(1):13–22 e1. doi: 10.1016/j.cgh.2015.07.041 - DOI - PubMed

MeSH terms

LinkOut - more resources