More about medications - specifically Anti-IL-5 (mepolizumab)

We talked briefly about a something-a-mab drug at the meeting tonight and it sounded interesting. I found some Wikipedia links describing cytokines and IL-5 - amazing. They're worth a read...and then another...and another. There's also a link to a report discussing the use of a medication specifically to treat EE. At a conference last summer the anti-IL-5 medication was mentioned a couple of times but it was stressed that the process to make it to production, cleared by the FDA, and then matched to the right patients was a loooong process.

Katy - help?

The links:

Cytokine Interleukin Interleukin-5


Anti-IL-5 (mepolizumab) therapy for eosinophilic esophagitis

Auteur(s) / Author(s)

STEIN Miguel L. ⁽¹⁾ ; COLLINS Margaret H. ⁽²⁾ ; VILLANUEVA Joyce M. ⁽³⁾ ; KUSHNER Jonathan P. ⁽⁴⁾ ; PUTNAM Philip E. ⁽⁵⁾ ; BUCKMEIER Bridget K. ⁽¹⁾ ; FILIPOVICH Alexandra H. ⁽³⁾ ; ASSA'AD Amal H. ⁽¹⁾ ; ROTHENBERG Marc E. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, ETATS-UNIS
⁽²⁾ Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, ETATS-UNIS
⁽³⁾ Division of Hematology /Oncology, Cincinnati Children's Hospital Medical Center, ETATS-UNIS
⁽⁴⁾ Digestive Diseases, University of Cincinnati College of Medicine, ETATS-UNIS
⁽⁵⁾ Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, ETATS-UNIS

What's your medication?

By the time I went in for a diagnosis we already strongly suspected that I had EE. Reading up about the condition after Liam was diagnosed brought up several things that seemed to point that direction for me: dysphagia, genetics, and probably some allergies.

I looked for as many scientific-like articles I could find that specifically mentioned the symptoms I had - didn't want to look like a hypochondriac. At the first appointment, with printed pages in hand, I brought up the dysphagia and suspicion of eosinophilic esophagitis. Being in the military, I expected a technicolor response from the PA peering over the top of his glasses. He didn't disappoint. So much for trying not to look like the hypochondriac. At least I didn't walk in and ask for drugs...

I was able to prove my case and made the cut to be scheduled for an upper GI (barium swallow) to look for structural problems and also get some blood work done to look for other stomach/intestinal problems...."It could be feline diabetes...." (another story)

40+ ounces of chalky "vanilla" fun later and a few pricks (both with normal results) I got to meet with an ENT. He was ready to prescribe flonase without further tests. Since we had already been through everything with Liam and been told that the only way to really diagnose was with an endoscopy, I opted for it. I was also still hoping like a lottery addict that I would win with the slim odds and not have it.

After the endoscopy and a confirmed diagnosis of EE, I was prescribed Flonase (fluticasone propionate - 50mcg) to be taken orally twice a day; two sprays each time. I've also found out that I'm allergic to milk, peanuts, and "clams" as well as every possible grass and tree. Since the chart didn't say "mussels" I'm still having ale and mussels mostly guilt free.... Since I had the EE diagnosis, food elimination with fluticasone *should* effectively treat it. We'll see at the next endoscopy.

So...what's the difference between flonase and flovent? Why prescribe one over the other? Should I be concerned about swallowing the "for intranasal use only" medicine? What about combining cromolyn with the anti-inflammatory?

What medications has everyone else been prescribed?