Dupilumab's use in the treatment of eosinophilic esophagitis

Abstract

Introduction: Eosinophilic esophagitis has increased in recent years. Its symptoms are disabling and affect the quality of life of its sufferers. Conventional treatment fails in many cases. The immunobiological drug dupilumab presents itself as an alternative in the treatment of this disease, by blocking the activity of Interleukin IL-4 and IL-13.Methodology: A bibliographical search was carried out on the Scielo, Virtual Health Library and PubMed platforms. In total, 1268 publications were identified, with the descriptors “eosinophilic esophagitis” and “dupilumab”. After methodological evaluation, 22 publications between 2019 and 2024 in Portuguese, Spanish and English were included. Results and Discussion: Dupilumab was able to reduce esophageal eosinophil counts and significantly improve esophageal histology in all presentations of the disease. In the fibrostenotic type, the medication achieved eosinophilic remission in 100% of the cases studied. Furthermore, it showed excellent results when used in the treatment of patients with other concomitant atopic pathologies. In some studies, the ability to improve the functionality of the esophagus was visualized. Symptom relief was recorded in most studies, but there was no unanimity. Conclusion: Dupilumab represents an important ally in the treatment of eosinophilic esophagitis refractory to first-line medications. However, its high cost and recent incorporation into the therapeutic range of this disease constitute challenges to be overcome. It is necessary to carry out new studies, especially in the long term, on the effectiveness of the drug, dose and duration required.