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REVIEW article

Front. Med.
Sec. Gastroenterology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1513417

Eosinophilic Esophagitis in the "atopic march": dupilumab as an "umbrella" strategy for multiple coexisting atopic diseases

Provisionally accepted
Nicola Lutzu Nicola Lutzu 1*Agnese Favale Agnese Favale 1Mauro Demurtas Mauro Demurtas 2*Stefano Del Giacco Stefano Del Giacco 1,2Sara Onali Sara Onali 1,2*Massimo Claudio Fantini Massimo Claudio Fantini 1,2*
  • 1 Department of Medical Sciences and Public Health, Faculty of Medicine and Surgery, University of Cagliari, Cagliari, Italy
  • 2 Azienda Ospedaliero-Universitaria Cagliari, Cagliari, Sardinia, Italy

The final, formatted version of the article will be published soon.

    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.

    Keywords: Esophagitis, Atopic march, anti-IL4, anti-IL13, Eosinophils, Dupilumab, Eosinophilic Esophagitis

    Received: 18 Oct 2024; Accepted: 24 Dec 2024.

    Copyright: © 2024 Lutzu, Favale, Demurtas, Del Giacco, Onali and Fantini. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Nicola Lutzu, Department of Medical Sciences and Public Health, Faculty of Medicine and Surgery, University of Cagliari, Cagliari, Italy
    Mauro Demurtas, Azienda Ospedaliero-Universitaria Cagliari, Cagliari, Sardinia, Italy
    Sara Onali, Department of Medical Sciences and Public Health, Faculty of Medicine and Surgery, University of Cagliari, Cagliari, Italy
    Massimo Claudio Fantini, Department of Medical Sciences and Public Health, Faculty of Medicine and Surgery, University of Cagliari, Cagliari, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.