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Targeted Therapies for Eosinophilic Gastrointestinal Disorders

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Abstract

The growing recognition of eosinophilic gastrointestinal disorders has revealed the limitations of current treatment (mainly based on dietary modification and corticosteroids), and include refractoriness, high recurrence rates, and the need for long-term therapy. Research efforts, mainly in eosinophilic esophagitis (EoE), have unveiled essential pathophysiological mechanisms leading to these disorders, which bear some similarities to those of atopic manifestations and are shared by eosinophilic gastroenteritis (EGE) and eosinophilic colitis (EC). Novel targeted therapies, some imported from bronchial asthma and atopic dermatitis, are currently being assessed in EoE. The most promising are monoclonal antibodies, including those targeting interleukin (IL)-13 (cendakimab) and IL-4 (dupilumab), with phase 3 trials currently ongoing. The potential of anti-integrin therapy (vedolizumab) and Siglec-8 blockers (antolimab) in EGE are also promising. Non-biological therapies for eosinophilic gut disorders, which include preventing the activation of Janus kinase (JAK)-signal transducer and activator of transcription (STAT) and chemoattractant receptor expressed on T helper 2 cells (CRTH2) signaling pathways, and other potential targets that deserve investigation in eosinophilic gut disorders, are reviewed.

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Authors and Affiliations

  1. Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n.,, 13700, Tomelloso, Ciudad Real, Spain

    Alfredo J. Lucendo

  2. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain

    Alfredo J. Lucendo

  3. Instituto de Investigación Sanitaria La Princesa, Madrid, Spain

    Alfredo J. Lucendo

  4. Division of Hospital Pharmacy, Hospital General de Tomelloso, Tomelloso, Spain

    Piedad López-Sánchez

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All authors contributed to the literature search, preparation of the manuscript and tables, editing, and referencing.

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A.J. Lucendo received honoraria as a consultant at EsoCap Biotech and received research funding from Regeneron Pharmaceuticals, Inc. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in, or financial conflict with, the subject matter or materials discussed in the article, apart from those disclosed. P. López-Sánchez has no conflict of interest.

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Lucendo, A.J., López-Sánchez, P. Targeted Therapies for Eosinophilic Gastrointestinal Disorders. BioDrugs 34, 477–493 (2020). https://doi.org/10.1007/s40259-020-00427-w

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