Allergen immunotherapy may help achieve remission in eosinophilic esophagitis

A recent review by Joshua Ang presented in the Scientific Abstract Session of American Academy of Allergy, Asthma & Immunology Annual Meeting found suggests that immunotherapy may improve clinical symptoms of eosinophilic esophagitis (EoE) and also assist in achieving remission.

The study reviewed literature published between 2007-2022 to evaluate the safety and efficacy of allergen immunotherapy in achieving remission or relief of symptoms in EoE, a condition triggered by environmental allergens. The review found that the use of immunotherapy to treat EoE has not been thoroughly investigated, but the limited evidence suggests that immunotherapy may improve clinical symptoms and assist in achieving EoE remission without causing any adverse events.

The review discussed three studies. The first was a double-blind, randomized controlled trial involving 20 pediatric patients, which found no significant difference in eosinophil count between patients receiving epicutaneous immunotherapy (EPIT) and placebo in the intent to treat group. However, in the per protocol population, 47% of the patients receiving EPIT achieved less than 15 eos/hpf at the end of the study, and symptoms were improved in the EPIT group compared to the placebo group.

The second study was an observational, longitudinal study that used targeted immunotherapy to specific environmental allergens to treat patients with EoE. At the end of follow-up, 75.2% of patients with EoE met discharge criteria, and no adverse events were reported in the immunotherapy group.

The third study was a retrospective cohort study that found no significant differences between the groups and no adverse events.

Overall, the review suggests that while evidence on the efficacy of immunotherapy in achieving EoE remission is limited, the results of these studies suggest that it may improve clinical symptoms and assist in achieving EoE remission without causing any adverse events. These findings may be helpful for patients with EoE who experience seasonal exacerbations. However, more research is needed to fully evaluate the safety and efficacy of immunotherapy in treating EoE.

Source: 

Ang, J., Khan, S., & Mele, S. (2023). Utility Of Allergen Immunotherapy In Eosinophilic Esophagitis. In Journal of Allergy and Clinical Immunology (Vol. 151, Issue 2, p. AB90). Elsevier BV. https://doi.org/10.1016/j.jaci.2022.12.288