Table 3.
Overview of the current best evidence available on biological therapies for the eosinophilic gastrointestinal diseases. Abbreviations: EoE: eosinophilic esophagitis; EoG: eosinophilic gastritis; EoN: eosinophilic enteritis; and EoC: eosinophilic colitis.
| EoE | EoG | EoN | EoC | |
|---|---|---|---|---|
| Benralizumab (anti-IL5Rα) | The study did not meet one of the two dual primary endpoints. Given the lack of clear benefit in this patient population, the study has been terminated (NCT04543409; phase III RCT). | Reduction of intraepithelial gastric eosinophil counts, but no other histologic modifications nor significant clinical improvement [127]. NCT05251909 has been interrupted. | Not evaluated. | Not evaluated. |
| Reslizumab (anti-IL5) | Reduction of intraepithelial esophageal eosinophil counts (Phase II and III RCTs) [71]. | Not evaluated. | Not evaluated. | Not evaluated. |
| Mepolizumab (anti-IL5) | Reduction of intraepithelial esophageal eosinophil counts (RCT) [73,74]. | Not evaluated. | Not evaluated. | Not evaluated. |
| Cendakimab (anti-IL13) | Endoscopic, histologic, and clinical improvements (phase II RCT) [76,77]. Phase III RCT is ongoing (NCT04753697). |
Currently being tested (phase III RCT) [130]. | Currently being tested (phase III RCT). | Not evaluated. |
| Dupilumab (anti-IL4R) | Endoscopic, histologic, and clinical improvements and/or remission [80]. Currently the only monoclonal antibody licensed for EoE (phase III RCT). |
Currently being tested (phase II RCT) [131]. | Currently being tested (phase II RCT) [131]. | Currently recruiting patients with ulcerative colitis and eosinophilic phenotype (phase II RCT) [152]. |
| Omalizumab (anti-IgE) | Failure in histologic and clinical improvements (phase II RCT) [81]. | Not evaluated. | Not evaluated. | Not evaluated. |
| Infliximab (anti-TNF) | Failure in histologic and clinical improvements (case series) [84]. | Not evaluated. | Not evaluated. | Not evaluated. |
| Tezepelumab (anti-TSLP) | Currently recruiting (NCT05583227; phase III RCT). | Not evaluated. | Not evaluated. | Not evaluated. |
| Etrasimod (S1P receptor modulation) | Currently being tested (NCT04682639; phase II RCT). |
Not evaluated. | Not evaluated. | Not evaluated. |
| Barzolvolimab (anti-KIT pathway) | Currently being tested (NCT05774184; phase II RCT). | Not evaluated. | Not evaluated. | Not evaluated. |
| Lirentelimab (anti-Siglec8) | Not evaluated. | Reduction of gastrointestinal eosinophils and symptoms (phase II RCT) [129]. Histologic improvement but no significant clinical improvement (NCT04322604 and NCT04856891; phase III RCT). |
Not evaluated. | Not evaluated. |
| Vedolizumab (anti-α4β7 integrin) | Not evaluated. | Histologic and clinical improvements (retrospective cohort study) [132]. | Not evaluated. | Not evaluated. |