EoE Module 10 References-Wechsler et al J Allergy Clin Immunol 2018 Biological therapies for eosinophilic gastrointestinal diseases

Wechsler et al J Allergy Clin Immunol 2018 Biological therapies for eosinophilic gastrointestinal diseases

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The document discusses the development of biological therapies targeting specific immune pathways for eosinophilic gastrointestinal diseases (EGIDs), particularly eosinophilic esophagitis (EoE), which is an area of growing scientific and clinical interest. Current treatments for EoE include topical corticosteroids, elimination diets, and esophageal dilation. These methods have limitations due to varying histological response rates, potential risks with long-term corticosteroid use, and the impact on quality of life due to dietary restrictions.<br /><br />Biologic therapies offer a promising alternative by targeting immune pathways to treat EoE and other EGIDs. These include biologic agents that target interleukin (IL)-5, IL-5 receptors, and IL-13, which play roles in TH2 inflammatory responses and eosinophil activity. Some clinical trials have shown that therapies targeting IL-4 and IL-13 pathways exhibit the most robust treatment benefits by improving esophageal eosinophilia and reducing symptoms like dysphagia.<br /><br />Validated outcome measures, such as patient-reported outcome instruments and histologic scoring, are essential for assessing the efficacy of these biologics. Recent trials have started to produce promising data, showing that IL-4 and IL-13-targeted therapies can achieve significant symptom reduction and esophageal healing. However, challenges remain, such as aligning symptom improvements with histologic and endoscopic outcomes and managing cases that do not respond to traditional treatments.<br /><br />Overall, biologics represent a new frontier in managing EGIDs with the potential to provide comprehensive treatment solutions. Future research will focus on refining these therapies to improve the quality of life for patients affected by these inflammatory conditions.

Keywords

biological therapies

eosinophilic gastrointestinal diseases

eosinophilic esophagitis

immune pathways

interleukin-5

interleukin-13

clinical trials

patient-reported outcomes

TH2 inflammatory response

biologic agents