Eosinophilic esophagitis in the “atopic march”: dupilumab as an “umbrella” strategy for multiple coexisting atopic diseases

Dupilumab is a monoclonal antibody targeting interleukin-4 and interleukin-13, approved for the treatment of multiple T2 diseases and more recently for Eosinophilic Esophagitis (EoE). EoE is a chronic T2 inflammatory disease, believed to be a member of the “atopic march”, due to multiple similaritie...

Full description

Saved in:
Bibliographic Details
Main Authors: Nicola Lutzu, Agnese Favale, Mauro Demurtas, Stefano Del Giacco, Sara Onali, Massimo Claudio Fantini
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2024.1513417/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832592401343971328
author Nicola Lutzu
Nicola Lutzu
Agnese Favale
Mauro Demurtas
Stefano Del Giacco
Stefano Del Giacco
Sara Onali
Sara Onali
Massimo Claudio Fantini
Massimo Claudio Fantini
author_facet Nicola Lutzu
Nicola Lutzu
Agnese Favale
Mauro Demurtas
Stefano Del Giacco
Stefano Del Giacco
Sara Onali
Sara Onali
Massimo Claudio Fantini
Massimo Claudio Fantini
author_sort Nicola Lutzu
collection DOAJ
description Dupilumab is a monoclonal antibody targeting interleukin-4 and interleukin-13, approved for the treatment of multiple T2 diseases and more recently for Eosinophilic Esophagitis (EoE). EoE is a chronic T2 inflammatory disease, believed to be a member of the “atopic march”, due to multiple similarities with other atopic diseases, ranging from epidemiology to genetics and pathophysiology. Although often co-existing in the same patient, these diseases are still treated as separated entities by different specialists, resulting in polypharmacy and chronic use of steroids. Thus, a shared-decision approach by a multidisciplinary team composed of different specialists might improve clinical management and outcomes. Yet, prospective data on the effectiveness of dupilumab as a single agent for multiple T2 inflammatory diseases are lacking, since only few case reports and small studies have been published so far reporting outcomes in patients affected by multiple T2 diseases. The purpose of this review is to illustrate the rationale and clinical evidence supporting the possibility of using dupilumab as a single therapeutic agent in those patients affected by multiple T2 diseases in addition to EoE.
format Article
id doaj-art-22991ff645f64883ae07520709734ccf
institution Kabale University
issn 2296-858X
language English
publishDate 2025-01-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-22991ff645f64883ae07520709734ccf2025-01-21T08:36:34ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011110.3389/fmed.2024.15134171513417Eosinophilic esophagitis in the “atopic march”: dupilumab as an “umbrella” strategy for multiple coexisting atopic diseasesNicola Lutzu0Nicola Lutzu1Agnese Favale2Mauro Demurtas3Stefano Del Giacco4Stefano Del Giacco5Sara Onali6Sara Onali7Massimo Claudio Fantini8Massimo Claudio Fantini9Department of Medical Science and Public Health, University of Cagliari, Cagliari, ItalyAzienda Ospedaliero-Universitaria di Cagliari, Cagliari, ItalyDepartment of Medical Science and Public Health, University of Cagliari, Cagliari, ItalyAzienda Ospedaliero-Universitaria di Cagliari, Cagliari, ItalyDepartment of Medical Science and Public Health, University of Cagliari, Cagliari, ItalyAzienda Ospedaliero-Universitaria di Cagliari, Cagliari, ItalyDepartment of Medical Science and Public Health, University of Cagliari, Cagliari, ItalyAzienda Ospedaliero-Universitaria di Cagliari, Cagliari, ItalyDepartment of Medical Science and Public Health, University of Cagliari, Cagliari, ItalyAzienda Ospedaliero-Universitaria di Cagliari, Cagliari, ItalyDupilumab is a monoclonal antibody targeting interleukin-4 and interleukin-13, approved for the treatment of multiple T2 diseases and more recently for Eosinophilic Esophagitis (EoE). EoE is a chronic T2 inflammatory disease, believed to be a member of the “atopic march”, due to multiple similarities with other atopic diseases, ranging from epidemiology to genetics and pathophysiology. Although often co-existing in the same patient, these diseases are still treated as separated entities by different specialists, resulting in polypharmacy and chronic use of steroids. Thus, a shared-decision approach by a multidisciplinary team composed of different specialists might improve clinical management and outcomes. Yet, prospective data on the effectiveness of dupilumab as a single agent for multiple T2 inflammatory diseases are lacking, since only few case reports and small studies have been published so far reporting outcomes in patients affected by multiple T2 diseases. The purpose of this review is to illustrate the rationale and clinical evidence supporting the possibility of using dupilumab as a single therapeutic agent in those patients affected by multiple T2 diseases in addition to EoE.https://www.frontiersin.org/articles/10.3389/fmed.2024.1513417/fullesophagitisatopic marchanti-IL4anti-IL13eosinophilsdupilumab
spellingShingle Nicola Lutzu
Nicola Lutzu
Agnese Favale
Mauro Demurtas
Stefano Del Giacco
Stefano Del Giacco
Sara Onali
Sara Onali
Massimo Claudio Fantini
Massimo Claudio Fantini
Eosinophilic esophagitis in the “atopic march”: dupilumab as an “umbrella” strategy for multiple coexisting atopic diseases
Frontiers in Medicine
esophagitis
atopic march
anti-IL4
anti-IL13
eosinophils
dupilumab
title Eosinophilic esophagitis in the “atopic march”: dupilumab as an “umbrella” strategy for multiple coexisting atopic diseases
title_full Eosinophilic esophagitis in the “atopic march”: dupilumab as an “umbrella” strategy for multiple coexisting atopic diseases
title_fullStr Eosinophilic esophagitis in the “atopic march”: dupilumab as an “umbrella” strategy for multiple coexisting atopic diseases
title_full_unstemmed Eosinophilic esophagitis in the “atopic march”: dupilumab as an “umbrella” strategy for multiple coexisting atopic diseases
title_short Eosinophilic esophagitis in the “atopic march”: dupilumab as an “umbrella” strategy for multiple coexisting atopic diseases
title_sort eosinophilic esophagitis in the atopic march dupilumab as an umbrella strategy for multiple coexisting atopic diseases
topic esophagitis
atopic march
anti-IL4
anti-IL13
eosinophils
dupilumab
url https://www.frontiersin.org/articles/10.3389/fmed.2024.1513417/full
work_keys_str_mv AT nicolalutzu eosinophilicesophagitisintheatopicmarchdupilumabasanumbrellastrategyformultiplecoexistingatopicdiseases
AT nicolalutzu eosinophilicesophagitisintheatopicmarchdupilumabasanumbrellastrategyformultiplecoexistingatopicdiseases
AT agnesefavale eosinophilicesophagitisintheatopicmarchdupilumabasanumbrellastrategyformultiplecoexistingatopicdiseases
AT maurodemurtas eosinophilicesophagitisintheatopicmarchdupilumabasanumbrellastrategyformultiplecoexistingatopicdiseases
AT stefanodelgiacco eosinophilicesophagitisintheatopicmarchdupilumabasanumbrellastrategyformultiplecoexistingatopicdiseases
AT stefanodelgiacco eosinophilicesophagitisintheatopicmarchdupilumabasanumbrellastrategyformultiplecoexistingatopicdiseases
AT saraonali eosinophilicesophagitisintheatopicmarchdupilumabasanumbrellastrategyformultiplecoexistingatopicdiseases
AT saraonali eosinophilicesophagitisintheatopicmarchdupilumabasanumbrellastrategyformultiplecoexistingatopicdiseases
AT massimoclaudiofantini eosinophilicesophagitisintheatopicmarchdupilumabasanumbrellastrategyformultiplecoexistingatopicdiseases
AT massimoclaudiofantini eosinophilicesophagitisintheatopicmarchdupilumabasanumbrellastrategyformultiplecoexistingatopicdiseases