[Dupilumab for eosinophilic esophagitis refractory to standard triple therapy]

We report the case of a young man presenting with dysphagia and frequent food impactions, which led to the diagnosis of eosinophilic esophagitis based on endoscopic examination and confirmed anatomopathologically. Despite a triple therapy regimen including a high-dose proton pump inhibitor, an elimination of allergenic foods based on prick tests, and oral budesonide, there was no significant and sustained clinical or endoscopic improvement. In this context, through a compassionate use program, we initiated biotherapy with dupilumab, a monoclonal antibody targeting interleukin 4 and interleukin 13 receptors, which was recently approved for the treatment of refractory eosinophilic esophagitis by the European Medicines Agency. We report our experience over 6 months with this innovative treatment, which has been reimbursed in Belgium under certain conditions since November 1st, 2024.