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Samantha Cooray, Alexander Deng, Tim Dong

There is much excitement about the deployment of artificial intelligence (AI) in healthcare, and the musculoskeletal field is no exception. In this article, we introduce some of the latest developments relating to osteoarthritis (OA), osteoporosis, rheumatoid arthritis (RA) (as an example of inflammatory arthritis), connective tissue disease (CTD), Ehlers–Danlos syndrome (EDS) and musculoskeletal surgical interventions. […]

Dupilumab an approved monoclonal antibody for eosinophilic esophagitis: Margaret Collins, DDW 2023

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Published Online: Jun 28th 2023

Dupilumab, a fully human monoclonal antibody that works by blocking IL-4Rα, is currently approved for the treatment of eosinophilic esophagitis (EoE) in the USA and EU. It was a pleasure to talk with Dr. Margaret Collins (Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA) around the mechanism of action of dupilumab and the impact its approval has already had on the treatment paradigm for EoE.

This information is brought to you by Touch Medical Media and is not sponsored by, nor a part of, the DDW.

The abstract ‘DUPILUMAB REDUCED EOSINOPHIL COUNTS AND IMPROVED HSS GRADE AND STAGE SCORES IN PATIENTS WITH EOSINOPHILIC ESOPHAGITIS: LIBERTY-EOE-TREET PHASE 3 STUDY PARTS A AND B.‘ (Abstract number: Sa1274) was presented at Digestive Disease Week 2023, May 6-9, 2023.

Questions

  1. What is the mechanism of action of dupilumab? (0:26)
  2. What impact has dupilumab already had on the treatment paradigm for eosinophilic esophagitis since its approval? (1:02)

Disclosures: Margaret Collins discloses consulting for Allakos, Arena/Pfizer, AstraZeneca, Calypso Biotech, EsoCap Biotech, GlaxoSmithKline, Receptos/Celgene/BMS, Regeneron Pharmaceuticals, Robarts Clinical Trials Inc./Alimentiv, Inc. and Shire, a Takeda company and serving on advisory boards for APFED, and CURED.

Support: Interview and filming supported by Touch Medical Media Ltd. Interview conducted by Victoria Jones.

Filmed in coverage of Digestive Disease Week 2023.

Click here for more content on digestive disorders.

Transcript

What is the mechanism of action of dupilumab? (00:25)

Dupilumab, with a brand name of Dupixent, is a fully human monoclonal antibody that inhibits signalling of the interleukin-4 and interleukin-13 pathways, which are the central drivers of type 2 inflammation and eosinophilic esophagitis, and other diseases. By doing this, dupilumab helps combat the excessive inflammation that is in overdrive through a novel approach but doesn’t suppress the entire immune system or compromise a person’s ability to fight infection.

What impact had dupilumab already had on the treatment paradigm for eosinophilic esophagitis since it’s approval? (01:02)

Eosinophilic esophagitis, also known as EoE, is a chronic progressive immune-mediated disease that affects the oesophagus. Eosinophils, a type of white blood cell, builds up in the lining of the oesophagus, resulting in inflammation, tissue damage, and oesophageal dysfunction. Disease can have wide-ranging symptoms that include dysphagia, chest pain, and vomiting. EoE also often has a substantial negative impact on health-related quality of life and patients will typically have periods of remission and relapse. Prior to Dupixent’s approval as the first and only targeted medicine specifically for EoE in adults and paediatric patients aged 12 and older in the US and EU, standard treatments for the disease included elimination diets, use of proton pump inhibitors, or PPIs, and steroid therapies. However, these treatments may not sufficiently control the inflammation characteristic of EoE, and some patients experience side effects and complications. Another treatment option is dilation of the oesophagus, a procedure to address structure or narrowing but dilation doesn’t address the underlying inflammation. Dupilumab changes the treatment paradigm for people who live with this challenging and misunderstood condition because physicians now have a medicine specifically approved for EoE for patients who continue to experience symptoms, despite trying other treatments. The fact that it addresses underlying inflammation to prevent or control disease progression is crucial for reducing the burden of this debilitating disease on the patients and their caregivers.

Subtitles and transcript are autogenerated

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