Ruth García-Romero, Gloria Domínguez-Ortega, Beatriz Espín-Jaime, Sonia Fernández-Fernández, Víctor Vila-Miravet, Julia Gonzalo-Consuegra, Iván Carabaño-Aguado, Alejandro García-Diaz, Ricardo Torres-Peral, José Vicente Arcos-Machancoses, Luis Grande-Herrero, Cristina Rodríguez-Jiménez, Laura Escartín-Madurga, Begoña Perez-Moneo, David Gil-Ortega, Mariana Di Campli-Zaghlul, Daniel Bordonaba-Bosque, Carolina Gutiérrez-Junquera
Dupilumab was effective and well tolerated, with sustained histological, clinical and endoscopic improvement.
BACKGROUND: Real-world paediatric data on dupilumab for eosinophilic esophagitis are scarce.
AIMS: To assess the effectiveness and safety of dupilumab in children and adolescents with eosinophilic esophagitis in routine clinical practice.
METHODS: This retrospective multicentre study included patients younger than 18 years treated with dupilumab in 13 Spanish centres between May 2022 and February 2025. Histological, clinical, patient-reported, endoscopic and safety outcomes were assessed at baseline and follow-up endoscopies.
RESULTS: Fifty-one patients were included; median age at dupilumab initiation was 13.7 years (IQR, 12.3-15.0). Most had previously received proton pump inhibitors (88.2%), swallowed topical corticosteroids (84.3%) and elimination diets (70.6%). Histological remission occurred in 30/45 patients (66.7%) at first follow-up and 15/19 (78.9%) at final follow-up. Deep histological remission occurred in 55.6% and 63.2%, respectively. Mean peak eosinophil counts decreased from 67 to 8.5 eosinophils/high-power field (p < 0.001). Symptom scores decreased by >60%, asymptomatic patients increased from 17.6% to 78.9%, and mean endoscopic score decreased from 3.2 to 0.9. Adverse events occurred in 18/51 patients (35.3%), all mild.
CONCLUSION: Dupilumab was effective and well tolerated, with sustained histological, clinical and endoscopic improvement.