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  • Efficacy of dupilumab in patients with prior exposure to topical steroids: facing second-line treatments for eosinophilic oesophagitis

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Letter
Efficacy of dupilumab in patients with prior exposure to topical steroids: facing second-line treatments for eosinophilic oesophagitis
  1. Pierfrancesco Visaggi1,
  2. Nicola De Bortoli1,
  3. Edoardo Savarino2
  1. 1 Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
  2. 2 Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy
  1. Correspondence to Professor Edoardo Savarino, Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, 35122, Italy; esavarino{at}libero.it

https://doi.org/10.1136/gutjnl-2023-331674

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    We read with interest the recent paper by Bredenoord et al,1 in which the authors performed a subgroup analysis of a phase 3 study of dupilumab 300 mg once a week (LIBERTY EoE TREET) showing that dupilumab was effective and well tolerated in patients with eosinophilic oesophagitis (EoE) regardless of prior topical corticosteroids (TCs) use or inadequate response, intolerance and/or contraindication (inadequate/intolerance/contraindication) to TCs. In this regard, it has also been shown that prior treatment with off-label TCs can have an impact on the response to proton pump inhibitors (PPIs) in EoE,2 while evidence on whether prior failure to respond to PPIs or off-label TCs impacts on medical or dietary second-line treatments is conflicting.3 4

    The results of Bredenoord et al 1 are positive and reassuring for practitioners but deserve a critical appraisal. In our recent systematic review with network meta-analysis,5 dupilumab 300 mg once a week for 24 …

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    Footnotes

    • X @Pierfra_Visaggi

    • Contributors PV, NDB and ES conceived and drafted the manuscript. All authors have approved the final draft of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests PV has served as speaker for Dr Falk; JB Pharmaceuticals. NDB has served as speaker for Reckitt Benckiser; Malesci; Sofar; Alfa-Sigma; Dr F; Cadigroup. ES has served as speaker for Abbvie, Agave, AGPharma, Alfasigma, Aurora Pharma, CaDiGroup, Celltrion, Dr F, EG Stada Group, Fenix Pharma, Fresenius Kabi, Galapagos, Janssen, JB Pharmaceuticals, Innovamedica/Adacyte, Malesci, Mayoly Biohealth, Omega Pharma, Pfizer, Reckitt Benckiser, Sandoz, SILA, Sofar, Takeda, Tillots, Unifarco; has served as consultant for Abbvie, Agave, Alfasigma, Biogen, Bristol-Myers Squibb, Celltrion, Diadema Farmaceutici, Dr. F, Fenix Pharma, Fresenius Kabi, Janssen, JB Pharmaceuticals, Merck & Co, Reckitt Benckiser, Regeneron, Sanofi, SILA, Sofar, Synformulas GmbH, Takeda, Unifarco; he received research support from Pfizer, Reckitt Benckiser, SILA, Sofar, Unifarco, Zeta Farmaceutici.

    • Provenance and peer review Not commissioned; internally peer reviewed.