NEW HORIZON FOR TREATMENT IN
Dupilumab: una valida alternativa nella gestione terapeutica dei pazienti con esofagite eosinofila
Giusy Russo, Salvatore Oliva
UOC di Gastroenterologia, Epatologia ed Endoscopia Digestiva Pediatrica Dipartimento Materno- infantile e Scienze Urologiche AOU Policlinico Umberto I, Sapienza – Università di Roma.
Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition characterized by eosinophilic infiltration of the esophageal mucosa and upper gastrointestinal symptoms, including dysphagia and esophageal food impaction. Historically, treatments options were limited to proton pump inhibitors and topical corticosteroids, which could nonspecifically counteract esophageal inflammation and led to good clinical and histological remission rates. However, there were notable rates of primary and relapsing non-responders, and poor compliance was often seen due to the need for daily dosing. Consequently, the scientific community sought new drugs that could selectively block molecules involved in the inflammatory process underlying EoE. Recently, Dupilumab, a fully human monoclonal antibody, has emerged as a promising option. This antibody effectively blocks the signaling of interleukin-4 and interleukin-13, cytokines that play a key role in the pathogenesis of EoE. Notably, it has recently received approval from Food and Drug Administration (FDA) and European Medicines Agency (EMA) for use in patients with active EoE aged 12 years and older. Dupilumab is administered subcutaneously on a weekly basis and has been demonstrated to reduce esophageal eosinophilia, alleviate disease symptoms, and improve endoscopic features. Importantly, it boasts a favorable safety and tolerability profile.