Dupilumab Can Induce Remission of Eosinophilic Gastritis and Duodenitis: A Retrospective Case Series.

Abstract

INTRODUCTION:

Noneosinophilic esophagitis eosinophilic gastrointestinal disorders (non-EoE-EGIDs) have limited treatment options to induce histologic and clinical remission. Dupilumab is a human monoclonal antibody against the interleukin-4 receptor ɑ subunit, which has been reported to induce improvement in pediatric patients with non-EoE-EGIDs.

METHODS:

We conducted a retrospective chart review to identify if patients with eosinophilic gastritis (EoG) and/or eosinophilic duodenitis (EoD) experience clinical and histologic remission with dupilumab.

RESULTS:

Twelve patients were included (2 patients with EoG and EoD, 3 patients with EoG only, and 7 patients with EoD only). All patients experienced improvement of at least 1 symptom on dupilumab, 3 patients (25%) had no change in severity of 1 or more of their symptoms, and no patients had worsening symptoms. On dupilumab, 2 patients with EoG (40%) and 3 patients with EoD (33.3%) were completely asymptomatic. Histologic changes were investigated in a subanalysis including 8 patients (2 patients with EoG and EoD, 2 patients with EoG only, and 4 patients with EoD only). Median peak gastric eosinophil counts in patients with EoG reduced from 80.5 eos/hpf (min-max 32-150, Q1-Q3 45.5-111) to 7.5 eos/hpf (min-max 0-28, Q1-Q3 1.5-16.8). Median peak duodenal eosinophil counts in patients with EoD reduced from 39 eos/hpf (min-max 30-50, Q1-Q3 37.3-46.3) to 16.5 eos/hpf (min-max 0-50, Q1-Q3 8-38.5). All 4 patients (100%) with EoG and 4 patients (66.6%) with EoD had histologic remission on dupilumab.

DISCUSSION:

In this retrospective case series, we showed preliminary evidence that dupilumab may be effective in inducing histologic and symptomatic remission in patients with non-EoE-EGIDs.

• Authors: Twan Sia, Leeon Bacchus, Riki Tanaka, Raisa Khuda, Shibani Mallik, John Leung
• Journal: Clinical and translational gastroenterology (Clin Transl Gastroenterol) Vol. 15 Issue 1 Pg. e00646 (01 01 2024) ISSN: 2155-384X [Electronic] United States
• PMID: 37753954 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.

Chemical References

• dupilumab
• Antibodies, Monoclonal, Humanized

Topics

• Humans
• Child
• Eosinophilic Esophagitis (diagnosis, drug therapy, pathology)
• Retrospective Studies
• Duodenitis (diagnosis, drug therapy)
• Enteritis
• Eosinophilia
• Gastritis
• Antibodies, Monoclonal, Humanized