A recent report highlights the use of anti-TNF therapy (eg. infliximab (IFX) and adalimumab [ADA]) for eosinophilic enterocolitis/eosinophilic gastroenteritis in eight patients who had not responded to other treatments (JPGN 2013; 56: 492-97).
The mean age of these patients was 8 years with a range of 1 to 14 years. Prior to use of IFX therapy, multiple therapies had been used. Four patients had been treated with complete elemental diet; medications that were used included montelukast, hydroxyzine, sodium cromogylcate, budesonide, amitriptyline, prednisone, ketotifen, cyproheptadine, thiopurines, and methotrexate (Table 1 in study).
Complete clinical remission was noted to occur in 6 (75%) with IFX induction treatment; this was associated with mucosal healing in 3, mucosal improvement in 2, and unknown in 1 patient.
The six responders were followed for a median of 7 years. During that timeframe, four of six had secondary loss of response and were switched to ADA. Three of these four maintained a clinical response with ADA using high doses (80 mg EOW).
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