The following is a summary of the “Biologics in eosinophilic gastrointestinal diseases,” published in the January 2023 issue of Allergy and Clinical Immunology by Dellon et al.

There is a spectrum of disorders known as eosinophilic gastrointestinal diseases, each defined by the site of eosinophil infiltration inside the gastrointestinal tract. The presence of eosinophils in a specific area, in addition to the patient’s age, can cause a wide range of symptoms. Currently, no FDA-approved treatments are available, while some people find relief through the unapproved use of steroids or dietary changes. 

Potential therapeutic targets for the treatment of eosinophilic esophagitis (EoE), gastritis (EoG), and enteritis (EoN) have been found through translational research. These targets include type 2 pathways, mast cells, and eosinophils. For example, Dupilumab(anti–IL-4 receptor alpha) and cendakimab (anti–interleukin [IL]-13) were recently licensed after preliminary tests showed they reduced eosinophil counts and improved symptoms.

Reduced eosinophils were also observed with the use of mepolizumab (anti-IL-5), reslizumab (anti-IL-5), and lirentelimab (anti-Siglec 8). Improvements in histology and symptoms were observed using both benralizumab (anti-IL-5 receptor) and lirentelimab in treating EoG and EoN. Eosinophilic colitis has not yet been the subject of any clinical trials. Expected outcomes from ongoing phase 3 trials of EoE and EoG/EoN.