Antibody treatment improves chronic food allergy symptoms in young adults, study finds

Medical Xpress / Children's Hospital of Philadelphia / New England Journal of Medicine ^ | Dec. 22, 2022 | Evan S. Dellon et al

[ConservativeMind]

A weekly dose of dupilumab, a monoclonal antibody, led to a reduction of symptoms and tissue improvement in young adults and adolescents with eosinophilic esophagitis (EoE), according to a new study. The study analyzed data from two phase 3 clinical trials.

EoE is a chronic food allergy that affects the esophagus, the tube that connects the mouth to the stomach. Triggered by certain foods, the disease occurs when eosinophils, a type of white blood cell, accumulate in the esophagus causing pain and injury.

Current treatments for EoE involve food elimination diets, proton-pump inhibitors (PPIs), swallowed topical glucocorticoids, and, in some cases, esophageal dilation. However, anywhere from 30 to 40% of patients may not respond to first-line treatments, and some treatments have unwanted side effects.

Given that growing evidence suggests type 2 cytokines play key roles in EoE, researchers have investigated using dupilumab to treat the condition. Dupilumab is a monoclonal antibody that blocks the shared receptor component for interleukin-4 and interleukin-13, two cytokines that are key and central drivers of type 2 inflammation.

Dupilumab is approved for several type 2 inflammatory diseases, including atopic dermatitis, asthma, and EoE, and a phase 2 trial involving adults with active EoE showed that a weekly 300mg dose of dupilumab reduced symptoms and improved esophageal tissue.

Researchers assessed the efficacy and safety of dupilumab in patients 12 years and older, with the treatment administered weekly or every two weeks, compared to placebo. They found 300mg of dupilumab given subcutaneously every week reduced symptoms and improved histologic outcomes, whereas a dose every other week improved histologic outcomes but did not improve symptoms.

Said Jonathan Spergel, MD, Ph.D.: "This study shows that dupilumab is a good treatment option for patients with EoE and not only reduces symptoms but also targets the root cause of the disease."

[ConservativeMind]

It’s a very expensive drug, but it works and is available.

[ConservativeMind]

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[ConservativeMind]

I stand corrected, the next drug writeup I will post describes a “very expensive drug.” This one is not that expensive, in comparison.

[G Larry]

Don't jump too soon!

a monoclonal antibody = mouse parts

I'm highly allergic to mice and narrowly avoided using a chemo treatment based on monoclonal antibodies many years ago. (that's what can happen if you think Google can confer an MD on you....)