Food allergy, anaphylaxis, dermatology, and drug allergyAnti–IL-5 (mepolizumab) therapy for eosinophilic esophagitis
Section snippets
Protocol
The study was conducted with the approval of the Institutional Review Board and the Food and Drug Administration and with informed consent from patients (clinicaltrials.gov, NCT00266565). Patients with EE had >24 peak eosinophils per hpf and no other pathology in other gastrointestinal segments. Patients, sequentially recruited, were monitored (for complete blood count, physical examination) every 2 weeks for a period of 28 weeks and were also evaluated at weeks 0, 8, and 20 by pulmonary
Patient characteristics
The subjects consisted of 2 male and 2 female patients with an age range of 18 to 41 years. Sequential patients with longstanding symptoms and histological diagnosis of EE but not other EGID were selected. Patients had EE symptoms for 9 or more years before enrollment (Table I, Table II summarize the clinical and pathological characteristics of the patients with EE before and after anti–IL-5 therapy). Patient 1, briefly described in another publication,27 had a progressive dysphagia to solid
Discussion
Eosinophilic esophagitis is a global disease that has been increasingly recognized over the last decade.10, 31 On the basis of the need for more effective therapy, we aimed to assess the safety and efficacy of anti–IL-5 as a new therapy for EE. Overall, our study demonstrates that anti–IL-5 therapy was associated with improvements in clinical symptoms, quality of life, endoscopic findings (in 3 of 4 patients), peripheral blood eosinophilia (6-fold reduction), and pathological features of EE
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Supported by grants from the Food and Drug Administration #FD-R 002313 and the Burroughs Wellcome Fund (M. E. Rothenberg), the Campaign Urging Research for Eosinophilic Diseases Foundation, and the Buckeye Foundation. M. L. Stein is a recipient of a fellowship from the American Physicians Fellowship for Medicine in Israel.
Disclosure of potential conflict of interest: M. E. Rothenberg has consultant arrangements with GlaxoSmithKline, Ception Therapeutics, Cambridge Antibody Technology, and MedaCorp; owns stock in Ception Therapeutics; has received grant support from Cambridge Antibody Technology; is on the speakers' bureau for Merck; and has received honoraria from GlaxoSmithKline, Ception Therapeutics, Merck, and Tanox. M. H. Collins and A. H. Assa'ad have consulting arrangements with and have received grant support from GlaxoSmithKline. The rest of the authors have declared that they have no conflict of interest.