Table 3

Trials using anti IL-5 antibody in eosinophilic oesophagitis

AuthorsStudy designAnti IL5Adult/ ChildNPrimary objective(s)Outcome(s)
Stein et al74Case seriesMepolizumab 3 infusionsAdult4Pronounced reduction in blood and oesophageal eosinophils
Straumann et al75Randomised placebo controlledMepolizumab 2 infusions 750 mg IV 1 week apart. After 2 months histological non-responders given a further 2 infusions 1500 mg 1 month apartAdults with ≥20 Eos/hpf)11Complete histological remission (<5 peak eosinophil number/hpf)

  1. 4 weeks after starting treatment, 54% reduction of mean oesophageal eosinophils in patients receiving active therapy compared with the placebo group (5%) (p<0.05)

  2. Reduced expression of tenascin C (p=0.033) and TGF-β (p=0.05) genes associated with oesophageal remodelling

  3. Trend towards clinical improvement observed after 4 and 13 weeks

Assa'ad et al76Randomised non-placebo controlledMepolizumab monthly infusion 0.55, 2.5, or 10 mg/kg for 3 monthsChildren with ≥20 Eos/hpf)59Histological improvementPeak and mean oesophageal intraepithelial eosinophil counts decreased significantly (p<0.0001). Symptoms were not recorded
Spergel et al77Randomised placebo controlledReslizumab, 1, 2 or 3 mg/kg IV (monthly intervals for 3 months)Children/ adolescent; symptom severity scores > moderate >24 Eos/hpf262Histological and clinical improvement

  1. Peak oesophageal eosinophil counts significantly reduced in the groups receiving reslizumab compared with placebo group (p<0.001)

  2. No significant difference between physician's global assessment scores

  • Eos, eosinophils; hpf, high powered field; IV, intravenous; TGF-β, transforming growth factor β.