Severe asthma with eosinophilic gastroenteritis effectively managed by mepolizumab and omalizumab

Han, Duhyun; Lee, Jason K.

doi:10.1016/j.anai.2018.07.030

Cited by 15 publications

(8 citation statements)

References 9 publications

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“…Combinations of these molecules may help address multiple disease processes at once, although costs may be a limiting factor as would be concerns about higher adverse effect risks and unintended consequences. 67 Investigation into immunotherapy has also begun, although more work is needed. The ongoing trials should pave the way for the first US Food and Drug Administrationeapproved medication for EoE and EGIDs and help drive disease modification with prevention of long-term complications.…”

Section: Discussionmentioning

confidence: 99%

Future therapies for eosinophilic gastrointestinal disorders

Pesek

Gupta

2020

Annals of Allergy, Asthma & Immunology

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Eosinophilic gastrointestinal disorders are T H 2-driven disorders characterized by eosinophilic inflammation of gastrointestinal tissues, epithelial barrier disruption, and long-term complications, including fibrosis.There are no US Food and Drug Administrationeapproved medications for eosinophilic gastrointestinal disorders, and current treatment options are limited.Significant progress has been made in understanding disease mechanisms, which has paved the way for development of new treatments.A variety of treatments are currently being investigated, several of which are in late-phase clinical trials.

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Section: Discussionmentioning

confidence: 99%

Future therapies for eosinophilic gastrointestinal disorders

Pesek

Gupta

2020

Annals of Allergy, Asthma & Immunology

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“…More recently, some case reports have described the association between asthma and eosinophilic gastritis in a few patients with severe asthma, treated with dupilumab or mepolizumab 41 ,. 42 Few data pertaining the association between eosinophilic gastritis with food allergy are available, while the majority of the studies has evaluated mainly sensitization to food allergens alone. Another limitation is represented by the inclusion of cases of concomitant EoE.…”

Section: Methodsmentioning

confidence: 99%

“…41,42 Few data pertaining the association between eosinophilic gastritis with food allergy are available, while the majority of the studies has T A B L E 2 (Continued)T A B L E 3 evaluated mainly sensitization to food allergens alone. Another limitation is represented by the inclusion of cases of concomitant EoE.…”

mentioning

confidence: 99%

Primary eosinophilic gastrointestinal disorders and allergy: Clinical and therapeutic implications

Rossi

Lenti

Merli

et al. 2022

Clinical & Translational All

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Primary eosinophilic gastrointestinal disorders (EGID) are increasingly prevalent, immune‐mediated, chronic conditions which primarily affect pediatric and young adult patients, leading to substantial disease burden, and poor quality of life. EGID may either involve single portions of the gastrointestinal tract (i.e., esophagus, stomach, small bowel, and colon) or a combination. Their strong association with allergic disorders has been recently recognized, and although their shared pathophysiological basis remains partly elusive, this feature greatly impacts the diagnostic and treatment work‐up. We herein critically discuss the current knowledge on the association of EGID and allergic disorders, including atopic dermatitis, allergic rhinitis, allergic asthma, and food or drug allergy. In particular, we reviewed the literature focusing on their epidemiology, pathophysiological basis and mechanisms, and diagnostic strategies. Finally, we discuss the currently ongoing clinical trials targeting EGID and allergic diseases, including, among others the monoclonal antibodies dupilumab, mepolizumab, benralizumab, and lirentelimab.

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“…More recently, studies have suggested a potential additional efect of benralizumab for depleting both blood and gastrointestinal tissue eosinophilia in some patients with eosinophilic gastrointestinal disorders (EGID), which may lead to a novel clinical indication for the use of this therapy. Nonetheless, the clinical response among patients using biologics seems heterogeneous, and the possible causative link between this EAD and immunotherapy is not completely known, which requires further investigation [7][8][9][10]. Tese are especially important given the unmet need in this feld for targeted therapies that can normalize the immune response to triggers, reduce chronic infammation, and limit or prevent remodeling and tissue fbrosis.…”

Section: Introductionmentioning

confidence: 99%

The Role of Benralizumab in Eosinophilic Immune Dysfunctions: A Case Report-Based Literature Review

Gomes

Mendes

Ferreira

et al. 2023

Case Reports in Medicine

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In the past years, the knowledge of eosinophils playing a primary pathophysiologic role in several associated conditions has led to the development of biologics targeting therapies aiming at normalizing the immune response, reducing chronic inflammation, and preventing tissue damage. To better illustrate the potential relationship between different eosinophilic immune dysfunctions and the effects of biological therapies in this scenario, here, we present a case of a 63-year-old male first referred to our department in 2018 with a diagnosis of asthma, polyposis, and rhinosinusitis and presenting a suspicion of nonsteroidal anti-inflammatory drugs’ allergy. He also had a past medical history of eosinophilic gastroenteritis/duodenitis (eosinophilia counts >50 cells/high-power field HPF). The use of multiple courses of corticosteroid therapy failed to completely control these conditions. In October 2019, after starting benralizumab (an antibody directed against the alpha chain of the IL-5 cytokine receptor) as add-on treatment for severe eosinophilic asthma, important clinical improvements were reported both on the respiratory (no asthma exacerbations) and gastrointestinal systems (eosinophilia count 0 cells/HPF). Patients’ quality of life also increased. Since June 2020, systemic corticosteroid therapy was reduced without worsening of gastrointestinal symptoms or eosinophilic inflammation. This case warns of the importance of early recognition and appropriate individualized treatment of eosinophilic immune dysfunctions and suggests the conduction of further larger studies on the use of benralizumab in gastrointestinal syndromes aiming at better understanding its relying mechanisms of action in the intestinal mucosa.

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Severe asthma with eosinophilic gastroenteritis effectively managed by mepolizumab and omalizumab

Cited by 15 publications

References 9 publications

Future therapies for eosinophilic gastrointestinal disorders

Future therapies for eosinophilic gastrointestinal disorders

Primary eosinophilic gastrointestinal disorders and allergy: Clinical and therapeutic implications

The Role of Benralizumab in Eosinophilic Immune Dysfunctions: A Case Report-Based Literature Review

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