Syverson Erin Phillips, Hait Elizabeth
Division of Gastroenterology and Nutrition, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
Gastroenterol Hepatol (N Y). 2022 Apr;18(4):207-212.
Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition identified by eosinophilic infiltration of the esophageal mucosa. Historically, pharmacologic options have been limited to proton pump inhibitors and swallowed topical corticosteroids, neither of which have been approved by the US Food and Drug Administration for the treatment of EoE. The goal of therapy is ultimately to avoid irreversible stricturing disease. Despite the rising prevalence of EoE, there have been few therapeutic advancements until recently. Some newer topical corticosteroid preparations are being studied, including a budesonide suspension (TAK-721), orodispersible tablet formulations of budesonide and fluticasone (APT-1011), and mometasone and ciclesonide preparations. Also in various stages of clinical trials are potential disease-modifying biologics such as dupilumab, cendakimab, lirentelimab, benralizumab, and mepolizumab. Some of these medications have proven efficacious for other atopic conditions and show incredible promise for the treatment of eosinophilic gastrointestinal diseases. Further studies will be needed to determine long-term treatment outcomes for each of these drugs.
嗜酸性食管炎(EoE)是一种慢性免疫介导性疾病,其特征为食管黏膜嗜酸性粒细胞浸润。从历史上看,药物治疗选择仅限于质子泵抑制剂和吞咽局部用皮质类固醇,这两种药物均未获得美国食品药品监督管理局批准用于治疗EoE。治疗的最终目标是避免不可逆的狭窄疾病。尽管EoE的患病率不断上升,但直到最近治疗方面的进展仍很少。一些新型局部用皮质类固醇制剂正在研究中,包括布地奈德混悬液(TAK-721)、布地奈德和氟替卡松的口腔崩解片制剂(APT-1011)以及莫米松和环索奈德制剂。处于临床试验不同阶段的还有潜在的疾病改善生物制剂,如度普利尤单抗、森达吉单抗、利伦替单抗、贝那利珠单抗和美泊利单抗。其中一些药物已被证明对其他特应性疾病有效,并且在治疗嗜酸性胃肠道疾病方面显示出巨大前景。需要进一步研究以确定每种药物的长期治疗效果。