Peer-reviewed article
Dupilumab in Eosinophilic Gastrointestinal Disorders With Extraesophageal Involvement: A Pediatric Case Series and Systematic Review.
Camille Braun, Kelly Grzywacz, Dorothée Dal Soglio, Eric Drouin, Marie E Chartier et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a medical case series and systematic review about dupilumab, a pharmaceutical treatment for eosinophilic gastrointestinal disorders in children. The study describes clinical outcomes in 8 patients treated at one centre and reviews 11 published case reports. The document is narrowly focused on a specific medical condition and drug treatment rather than broader child well-being.
Key points
- All 8 patients in the case series showed symptom improvement after dupilumab treatment
- Three patients had growth retardation related to their condition
- All 11 case reports in the systematic review reported significant clinical and histological improvement
- Patients had recurrent gastrointestinal symptoms refractory to standard treatments
Limitations
This is a case series and systematic review of case reports without experimental design or comparison groups, so causation cannot be definitively established. The rarity of the condition limits generalisability and the evidence base remains weak pending randomized controlled trials.
Abstract
Dupilumab has proven effective in the treatment of eosinophilic esophagitis (EoE) in randomized controlled trials. Its efficacy in other, less common and generally more severe eosinophilic gastrointestinal disorders (EGIDs) is scientifically plausible, although it has not been studied to date. Our objective was to describe published and our experience on the empirical use of dupilumab in patients affected by EGIDs with extraesophageal involvement. We retrospectively analyzed the medical charts of children diagnosed with extraesophageal EGIDs treated with dupilumab at our tertiary medical center. The Medline, Embase, and Cochrane databases were searched up to January 2025 for articles describing the use of dupilumab in patients with diagnosed or suspected extraesophageal EGID. Our cohort included 8 patients with a clinical and histological diagnosis of EGID and extraesophageal involvement. All of them had recurrent gastrointestinal symptoms refractory to standard treatments. Three patients had growth retardation. In all patients, symptoms and macroscopic and histological abnormalities, including eosinophilic infiltration, quickly improved after initiation of dupilumab. The systematic review identified 11 case reports (n=29 patients) of pediatric and adult patients with extraesophageal EGIDs treated with dupilumab. All 11 reports described significant clinical and histological improvement following therapy. Clinical experience suggests that dupilumab is effective in treating pediatric EGIDs with extraesophageal features. Given the rarity and high morbidity of these disorders, dupilumab could be considered a reasonable option while waiting for high-quality evidence from ongoing randomized controlled trials.