Dupilumab for paediatric eosinophilic esophagitis: a multicentre real-world study.

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.