An Antibody Against IL-5 Reduces Numbers of Esophageal Intraepithelial Eosinophils in Children With Eosinophilic Esophagitis

Assa’ad, Amal; Gupta, Sandeep K.; Collins, Margaret H.; Thomson, Mike; Heath, Amy; Smith, Deborah A.; Perschy, T.; Jurgensen, Cynthia H.; Ortega, Héctor; Aceves, Seema S.

doi:10.1053/j.gastro.2011.07.044

Cited by 370 publications

(251 citation statements)

References 30 publications

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“…Among the interventional trials (randomized controlled trial studies [RCTs] or trials with historical controls), 80 (80%) compared treatment effect using histological remission as values within the range of 0 to ≤5 eosinophils/hpf. Among studies that examined the effectiveness of monoclonal antibody treatment in EoE subjects, 80% defined histological remission as peak esophageal eosinophil counts within the range of 0 to ≤5 24, 25, 26, 27, 28. Approximately 26% (N = 15) of the eligible studies examined remission among EoE patients who received only the diet elimination treatment formula (SFED, FFGED, ELED) compared to other forms of treatment, with the most common definitions falling within 0 to ≤5 eosinophils/hpf 29, 30, 31, 32, 33, 34 or 11 to ≤15 eosinophils/hpf 35, 36, 37, 38, 39, 40.…”

Section: Resultsmentioning

confidence: 99%

“…3). Others included a prospective open clinical trial conducted in Australia and an international multicenter randomized control trial 27, 43. Among published studies from the United States, the definition of remission ranged from <1 eosinophil/hpf to ≤15 eosinophils/hpf; 44% of the studies from the United States considered histological remission within the range of 0 to ≤5 eosinophils/hpf, while about 30% considered values within the range of 11 to ≤15 eosinophils/hpf.…”

Section: Resultsmentioning

confidence: 99%

“…diet elimination or restriction), we observed that medication trial studies (e.g. steroids, monoclonal antibody) used more rigorous criteria in their definition of histological remission in study subjects with EoE 21, 26, 27, 35, 53, 60. It is possible that different cut‐off values of peak eosinophil counts per hpf are appropriate for the definition of histological improvement because of the variations in the trial methodology (treatment, subjects’ characteristics).…”

Section: Discussionmentioning

confidence: 99%

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Systematic review of histological remission criteria in eosinophilic esophagitis

Eke

White

et al. 2018

JGH Open

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Elemental diets, dietary elimination, and steroid therapies are the most common therapies in the clinical trials for eosinophilic esophagitis (EoE). Histological findings (usually reported as eosinophils per microscopic high‐powered field [hpf]) remain the most common end‐point used to define response. Yet, the threshold for defining “response” and “remission” are ill‐defined among consensus guidelines and may vary from study to study. We conducted a systematic literature review of articles on eosinophilic esophagitis, published between January 2007 and November 2017, considering histological remission as the primary outcome. We abstracted treatment information and definitions of histological remission or response. A comparison of definitions of histological remission across and within institutions was performed. A total of 61 articles were included in this review, with approximately 60% of the studies published from centers in the United States. Histological definitions of remission of EoE ranged from 0 to ≤20 eosinophils/hpf. The most stringent criteria, ranging from 0 to ≤5 eosinophils/hpf, were commonly used in interventional trial studies that examined the effects of new treatments. We found remarkable variability in definitions between studies, treatment types, and regions. Age or epidemiological distribution of study subjects did not influence the criteria for histological remission. Clinical and histological improvements are important measures of the effects of treatment. Histological findings, the most objective measure of treatment, should provide an optimal method for comparing the effectiveness of various treatments. Yet, our findings suggest a lack of consistent remission criteria in published studies. Considering these inconsistencies, it is difficult to compare the effectiveness of various treatments.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Systematic review of histological remission criteria in eosinophilic esophagitis

Eke

White

et al. 2018

JGH Open

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“…An initial open labeled trial of 4 patients in 2006 receiving mepolizumab, showed both a reduced esophageal eosinophilic count and improvement in symptoms. Two larger trials including a RCT of 59 children receiving mepolizumab, showed a decrease in eosinophilic count, however not a significant change in symptoms [64][65][66]. In a 2012 study, 226 children and adolescents with EoE were given reslizumab with significant improvement in intraepithelial esophageal eosinophil counts.…”

Section: Biological Agentsmentioning

confidence: 99%

Eosinophilic Esophagitis–More than Two Decades of Progress

Rahimi

Ertan

2015

JGPLD

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“…Although the monoclonal antibody against IL-5, mepolizumab is approved for asthma with an eosinophilic phenotype, and studies have considered its use for eosinophilic esophagitis [111]. Limited studies demonstrate that mepolizumab reduces intraepithelial eosinophils in children and adults, though efficacy with reducing symptoms is lacking [112,113].…”

Section: Eosinophilic Esophagitismentioning

confidence: 99%

The Impact of Therapeutic Antibodies on the Management of Digestive Diseases: History, Current Practice, and Future Directions

Sofia

Rubin

2017

Dig Dis Sci

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The development of therapeutic antibodies represents a revolutionary change in medical therapy for digestive diseases. Beginning with the initial studies that confirmed the pathogenicity of cytokines in inflammatory bowel disease, the development and application of therapeutic antibodies brought challenges and insights into their potential and optimal use. Infliximab was the first biological drug approved for use in Crohn's disease and ulcerative colitis. The lessons learned from infliximab include the importance of immunogenicity and the influence of pharmacokinetics on disease response and outcomes. Building on this foundation, other therapeutic antibodies achieved approval for inflammatory bowel disease and many more are in development for several digestive diseases. In this review, we reflect on the history of therapeutic antibodies and discuss current practice and future directions for the field.

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An Antibody Against IL-5 Reduces Numbers of Esophageal Intraepithelial Eosinophils in Children With Eosinophilic Esophagitis

Cited by 370 publications

References 30 publications

Systematic review of histological remission criteria in eosinophilic esophagitis

Systematic review of histological remission criteria in eosinophilic esophagitis

Eosinophilic Esophagitis–More than Two Decades of Progress

The Impact of Therapeutic Antibodies on the Management of Digestive Diseases: History, Current Practice, and Future Directions

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