Weekly administration of subcutaneous dupilumab alleviates symptoms of eosinophilic esophagitis

A recent study published in The New England Journal of Medicine suggests that weekly administration of subcutaneous dupilumab can improve histologic outcomes and alleviate symptoms of eosinophilic esophagitis.

This phase three trial included patients 12 years of age or older, and it was conducted in three parts: Part A - participants received subcutaneous dupilumab at a weekly dose of 300 mg or placebo; Part B - participants received 300 mg of dupilumab either weekly or every 2 weeks or weekly placebo up to week 24; eligible patients who completed Part A or Part B continued the trial in Part C. In Part C, participants who completed Part A received dupilumab at a weekly dose of 300 mg up to week 52 (the Part A-C group). The primary end points at week 24 were histologic remission and the change from baseline in the Dysphagia Symptom Questionnaire (DSQ) score.

In Part A, histologic remission occurred in 60% of the patients who received weekly dupilumab and in 5 % of patients who received placebo. In Part B, histologic remission occurred in 59% of patients with weekly dupilumab, in 60% of patients with dupilumab every 2 weeks, and in 6% of patients with placebo.  The mean DSQ scores improved with weekly dupilumab as compared with placebo, but not with dupilumab every 2 weeks.

Therefore, weekly administration of subcutaneous dupilumab improves histologic outcomes and alleviates symptoms of eosinophilic esophagitis.

Cognitive behavioural therapy is effective in reducing insomnia and IBS symptoms

According to the findings of a recent study, cognitive behavioural therapy was helpful in reducing insomnia, Irritable Bowel Syndrome (IBS) and IBS quality of life (QOL).

The results were published in International Journal of Environmental Research and Public Health. The study aimed to develop and evaluate cognitive behavioural therapy for insomnia (CBT-I) among 60 college students with IBS comorbid insomnia. They were randomly assigned to the experimental group, which received CBT-I for 90 minutes once a week for 4 weeks, and the control (non-CBT-I) group.

Participants who completed self-report measures at baseline, after intervention, and at the 3-month follow-up, were included. When compared to the control group, the experimental group showed significant reductions in insomnia severity, sleep onset latency, total time in bed, pre-sleep arousal, GI symptoms during sleep, sleep-related dysfunctional cognitions, maladaptive sleep habits, and IBS symptom severity. Hence, it was found that CBT-I may significantly increase sleep efficiency and IBS QOL.

Esophageal cancer patients can benefit through supplemental parenteral nutrition

The findings of a recent study indicate that supplemental parenteral nutrition can be  helpful in maintaining optimal postoperative nutritional status, improved immune function and reduced inflammatory stress response in perioperative esophageal cancer patients.  

The results of the study were published in the journal, Medicine (Baltimore). It was a single-center randomized controlled study that included seventy-two patients diagnosed with esophageal cancer. They were divided equally into two groups- one with a combination of parenteral nutrition PN) and enteral nutrition (EN) and the other, a control group (total EN [TEN]). The PN + EN group received the combined nutritional supplement on postoperative days 4 to 8 while the control group was administered EN on postoperative days 1 to 8.

Before surgery, the prealbumin values of both groups were lower than normal, and the C-reactive protein (CRP) levels were above normal. The IgA, IgG and CD4 levels were lower than normal.

On postoperative day 7, prealbumin levels of the PN + EN group were significantly higher, the C-reactive protein level was significantly lower, and IgA, IgG, and CD4 were significantly higher, than that of the TEN group.

Based on the results of the study, supplemental parenteral nutrition can be beneficial for perioperative esophageal cancer patients in maintaining optimal nutritional status, improving immune function, and reducing the inflammatory stress response. 

Enterosgel is safe and effective alternative treatment option for Irritable Bowel Syndrome

The findings of a recent study indicate that an intestinal absorbent, Enterosgel (polymethylsiloxane polyhydrate) is safe and effective in treating irritable bowel syndrome with diarrhoea (IBS-D).  

The study was published in the journal Gut. The double-blinded, randomized, placebo controlled trial included 440 patients initially with IBS-D and 393 entering into the open-label phase. The primary outcome of the study was abdominal pain and stool consistency during at least 4 weeks of the treatment period.

The responder rate of the primary outcome for enterosgel versus placebo was 37.4% versus 24.3%. It was found that enterosgel improved stool consistency, frequency, and urgency as well as abdominal pain.

Thus, it may be concluded that enterosgel is safe and effective for controlling symptoms of IBS-D.