Dear friends of the Cincinnati Center for Eosinophilic Disorders (CCED),
The Food and Drug Administration (FDA) recently approved dupilumab (brand name Dupixent) for treatment of eosinophilic esophagitis (EoE) in patients 12 years and older.
We are hopeful that Dupixent will simplify the management of EoE for some patients. However, the studies that have demonstrated its efficacy have not included an assessment of the response to the addition of foods to the diet or cessation of topical steroids [(i.e., fluticasone (Flovent) and budesonide (Pulmicort)] so there is still much to be learned about the use of this medication for EoE.
All patients 12 years and older who have EoE can be evaluated for the use of dupilumab (Dupixent). It is not effective in all cases of EoE, and there is risk of serious allergic reactions, severe increased eosinophils, or eye and skin inflammation. Because of these risks, it may not be appropriate for all patients.
Patients whose EoE is in remission with common treatments, such as an elimination diet or topical steroids, should not alter their therapy until discussed with their physician.
We will be evaluating each patient with EoE for the use of Dupixent at their next appointment and look forward to discussing the risks and benefits of this possible treatment with each patient personally to determine the best personalized care plan.
Established patients who are in the process of participating in food trials, or whose medication dose has been changed, should continue with their therapy as prescribed.
It is possible that insurance coverage for Dupixent will be challenging if, as yet undefined criteria are not met for its use. We encourage all families to remain patient and vigilant as we navigate through these new waters.
At this time, Dupixent has not been approved for any other eosinophilic gastrointestinal condition, such as eosinophilic gastritis (EoG), eosinophilic duodenitis (EoD), or eosinophilic colitis (EoC).
- CCED staff