Current and emerging biologic therapies targeting eosinophilic disorders

Area of Science:

• Immunology
• Allergy
• Gastroenterology

Background:

• Eosinophilic disorders involve eosinophils in disease.
• Traditional treatments include corticosteroids and immunosuppressants.
• Advances in eosinophil biology have led to targeted biologic therapies.

Purpose of the Study:

• To review current FDA-approved and investigational biologics targeting eosinophils.
• To discuss the efficacy and safety of these biologics in various eosinophilic conditions.
• To highlight the evolving landscape of biologic treatments for eosinophilic disorders.

Main Methods:

• Review of current US Food and Drug Administration (FDA) approved biologics targeting IL-5 (mepolizumab, reslizumab) and IL-5R (benralizumab).
• Discussion of investigational biologics targeting siglec-8 (lirentelimab).
• Analysis of clinical trial data and case reports for conditions including eosinophilic asthma, HES, EGPA, CRSwNP, EoE, EGID, DRESS, ABPA, and eosinophilic pneumonia.

Main Results:

• Biologic therapies targeting eosinophils are FDA-approved and effective for eosinophilic asthma, HES, EGPA, and CRSwNP.
• Investigational biologics show potential for other eosinophilic conditions.
• Trials for eosinophilic esophagitis (EoE) and eosinophilic gastrointestinal disease (EGID) have yielded disappointing results to date.

Conclusions:

• Eosinophil-specific biologic therapy has transformed the management of several eosinophilic disorders.
• Ongoing research and trials are expanding treatment options.
• Allergist-immunologists must stay current with these advancements for optimal patient care.