The Latest Drugs to Deal with EoE – Biologics
The latest drugs on the scene to help deal with EoE are called Biologics and they show a lot of promise for finding relief. Here are some details about these drugs:
1) The term “Biologic” is for drugs that are developed from living organisms, and are at the forefront of medical advances today. They are more complicated to produce, and because of that are very expensive. They typically are injections instead of taken orally. That’s because the proteins involved are digested and inactivated if taken orally.
2) They are NOT approved for treatment of EoE, although they ARE FDA approved for treating Eosinophilic Athsma, Eczema or other “Eosinophil” related conditions. The FDA has classified Fasenra as an “orphan drug“.
3) Your insurance “might” not cover these drugs for EoE, but there may be options to have them paid for (through the manufacturer for example, or drug trials).
4) These drugs have been shown to eliminate eosinophil cells, and theoretically will heal your symptoms because of that.
5) IF your condition is driven mainly by eos (eosinophils), you will likely find relief from these drugs.
6) Some of these drugs “may” affect more than just eos, and other white blood cells may be affected as well and “may” slightly affect your immune response (using some of the stronger ones like Dupixent, but not likely with Fasenra).
7) Some people have been on these drugs for years and have experienced remission of EoE for a long term.
8) If you go off of these drugs, and need to go back on them, your chances of becoming allergic to them may be increased.
9) These biologic drugs are done via shots. For example, Fasenra is a monthly shot for 3 months, then bi-monthly for as long as you’re on it (going off these drugs will result in recurrence of symptoms since they are not a “cure”).
Currently biologics show great promise in treating EoE. It’s likely they will take care of the eos for you, but whether your symptoms will disappear depends on if eos are the root cause of your inflammation or other issues.
In Europe we have the first drug ever that is approved specifically for EoE. It is called Jorveza. It’s 1 mg Budesonide as orodispersible tablets (very innovative galenics). I made very good experiences with it: no EoE symptoms and no side effects. The drug is supposed to have a local effect (in the esophagus only) and thus the required dose of budesonide is very low (1 mg twice a day). Unfortunately, we are still waiting for long-term approval. By now it is only approved for 12 weeks. I hope that this drug will be approved world-wide. It is really worth waiting for this drug as it is very effective for most of the patients and the dose is quite low combined with a local effect leading to less side effects.
You can find information about Jorveza e.g here: https://www.ema.europa.eu/en/medicines/human/EPAR/jorveza