Dupilumab as an effective therapy for eosinophilic esophagitis in pediatric patients weighing less than 15 kilograms
Bibliographic record
Abstract
Objectives: Eosinophilic esophagitis (EoE) is a type 2 cytokine-mediated chronic inflammatory condition leading to esophageal dysfunction. Dupilumab blocks IL-4 and IL-13 signaling, which are key inflammatory mediators in EoE and other allergic disorders. In the United States, the Food and Drug Administration (FDA) has approved the use of dupilumab in children and adults with doses that vary by age, weight and indication. Dupilumab is currently approved for EoE in children above 1 year of age and weight greater than 15 kg. There is an unmet need to extend the use of dupilumab for children with EoE below this weight threshold and there is a paucity of data. We seek to describe the safety and efficacy of dupilumab in treating EoE at doses approved for eczema in children weighing less than 15 kg. Methods: The retrospective chart review was approved by the Institutional Review Board (IRB) at Children's Hospital Los Angeles. A search for patients with a diagnosis of EoE treated with dupilumab for any indication between 2019 and 2024 identified four patients weighing less than 15 kg. Results: This report highlights a single-center experience with dupilumab in four patients with EoE weighing less than 15 k. All patients had clinical improvement. Three patients had follow-up endoscopy demonstrating endoscopic and histologic improvement. No significant adverse effects were noted. Conclusions: In our limited experience, dupilumab was safe and effective in four EoE patients weighing less than 15 kg using the FDA-approved dose for atopic dermatitis. Prospective trials are needed to optimize dosing and provide comprehensive safety and efficacy data.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".