Collins Margaret H, Rothenberg Marc E, Dellon Evan S, Bredenoord Albert J, Hirano Ikuo, Leung John, Sun Xian, Glotfelty Lila, Shabbir Arsalan
Division of Pathology and Laboratory Medicine, Cincinnati Hospital Medical Center, Cincinnati, Ohio.
Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio.
Gastro Hep Adv. 2025 Feb 24;4(6):100646. doi: 10.1016/j.gastha.2025.100646. eCollection 2025.
This post hoc analysis assessed the effect of dupilumab on the individual components of the Eosinophilic Esophagitis Histology Scoring System (EoEHSS) and the relationship between histopathologic and endoscopic measures in the LIBERTY eosinophilic esophagitis (EoE) TREET population.
The analysis included patients who received dupilumab 300 mg weekly (qw) or placebo for 24 weeks (Parts A and B). Eligible patients who completed Parts A or B entered Part C and received dupilumab 300 mg qw for 28 weeks (week 52). Changes from baseline to week 24 and week 52 in the EoEHSS grade/stage components were assessed. Associations between histopathologic, symptomatic, and endoscopic features were evaluated using Spearman correlation.
At week 24, dupilumab improved most EoEHSS grade/stage component scores vs placebo. These improvements were sustained at week 52 in patients continuously on dupilumab; patients who switched from placebo to dupilumab at week 24 improved EoEHSS grade/stage component scores at week 52 to levels similar to those observed in patients continuously on dupilumab. Dupilumab also increased the proportion of patients in remission at week 24 vs placebo, with further increases at week 52, as assessed by the EoE histology remission score. EoEHSS grade and stage total scores correlated strongly with peak eosinophil count (PEC), moderately to strongly with Endoscopic Reference Score, and weakly with Dysphagia Symptom Questionnaire score. Several EoEHSS grade/stage component scores correlated strongly with PEC but not with Dysphagia Symptom Questionnaire scores.
Dupilumab 300 mg qw improved histopathologic measures of EoE beyond PEC at week 24, with improvements sustained to week 52 (Video 1).
本事后分析评估了度普利尤单抗对嗜酸性食管炎组织学评分系统（EoEHSS）各个组成部分的影响，以及在LIBERTY嗜酸性食管炎（EoE）TREET研究人群中组织病理学与内镜检查指标之间的关系。
该分析纳入了接受度普利尤单抗300mg每周一次（qw）或安慰剂治疗24周的患者（A部分和B部分）。完成A部分或B部分的合格患者进入C部分，并接受度普利尤单抗300mg qw治疗28周（第52周）。评估了从基线到第24周和第52周EoEHSS分级/分期组成部分的变化。使用Spearman相关性评估组织病理学、症状和内镜特征之间的关联。
在第24周时，与安慰剂相比，度普利尤单抗改善了大多数EoEHSS分级/分期组成部分的评分。在持续使用度普利尤单抗的患者中，这些改善在第52周时得以维持；在第24周从安慰剂转换为度普利尤单抗的患者，其EoEHSS分级/分期组成部分的评分在第52周时改善至与持续使用度普利尤单抗的患者相似的水平。根据EoE组织学缓解评分评估，与安慰剂相比，度普利尤单抗在第24周时也增加了缓解患者的比例，在第52周时进一步增加。EoEHSS分级和分期总分与嗜酸性粒细胞峰值计数（PEC）密切相关，与内镜参考评分中度至密切相关，与吞咽困难症状问卷评分弱相关。几个EoEHSS分级/分期组成部分的评分与PEC密切相关，但与吞咽困难症状问卷评分无关。
度普利尤单抗300mg qw在第24周时改善了EoE的组织病理学指标，超出了PEC，且改善持续至第52周（视频1）。
