Biologics in eosinophilic gastrointestinal diseases

Eosinophilic gastrointestinal diseases are a constellation of conditions categorized by the location of eosinophilic infiltration in the gastrointestinal tract. Symptoms vary based on location of eosinophils and age of the patient. There are no approved medications at the current time with individuals using off-label steroids or dietary ther-apy. Translational research has identified potential pathways to target in the treatment of eosinophilic esophagi-tis (EoE), gastritis (EoG), and enteritis (EoN), including type 2 pathways, mast cells, and eosinophils. Preliminary studies found cendakimab (anti-interleukin [IL]-13) and dupilumab (anti-IL-4 receptor alpha) to have an effect on eosinophil count and symptoms with dupilumab recently approved. In addition, mepolizumab (anti-IL-5), reslizumab (anti-IL-5), and lirentelimab (anti-Siglec 8) were found to have reduction in eosinophils without reduction of symptoms. For EoG and EoN, both benralizumab (anti-IL-5 receptor) and lirentelimab were found to have histologic and symptom improvement. There are no agents studied for eosinophilic colitis. Results of ongoing phase 3 trials in EoE and EoG/EoN are also anticipated & COPY; 2022 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc.

Automated summary

Eosinophilic gastrointestinal diseases are a group of conditions categorized based on the location of eosinophilic infiltration in the gastrointestinal tract. Current treatment options include off-label steroids and dietary therapy. Research has identified potential pathways to target in the treatment of these diseases, and some medications such as cendakimab and dupilumab have shown promise in reducing eosinophil count and symptoms. Ongoing phase 3 trials are being conducted to further evaluate the effectiveness of these treatments.