{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T10:10:57Z","timestamp":1778062257664,"version":"3.51.4"},"reference-count":14,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Eosinophilic esophagitis (EoE) is a chronic, immune\u2010mediated disease requiring long\u2010term therapy. Dupilumab, an interleukin\u20104 and interleukin\u201013 receptor antagonist, is approved for EoE at a weekly 300\u2009mg dosing regimen. However, data on reduced\u2010frequency dosing, especially in pediatric patients, remain limited. This is the case of a 12\u2010year\u2010old girl presented with vomiting, food impaction, and dysphagia. Endoscopy revealed longitudinal furrows and whitish exudates (EREFS 4), and histology confirmed EoE with 75 eosinophils\/high\u2010power field (HPF) and high EoEHSS grade and stage scores. Conventional therapies with proton pump inhibitors, topical fluticasone, and an elimination diet achieved only partial improvement. Dupilumab (300\u2009mg every 2\u2009weeks) induced complete clinical, endoscopic (EREFS 0), and histologic remission (EoEHSS grade\/stage 0\u20131, peak &lt;\u20096 eos\/HPF) after 6 months. Given the remission and parental concern about prolonged therapy, the dosing interval was cautiously extended to every 3\u2009weeks as a monitored off\u2010label trial. Topical steroids and dietary restrictions were discontinued. The patient remained asymptomatic and in complete histologic remission for more than 2\u2009years (as of August 2025: EREFS 0, EoEHSS 0, with a peak eosinophil count of \u2264\u20096 eos\/HPF) without any adverse events. This case illustrates that sustained remission of pediatric EoE may be achievable with individualized, response\u2010based dupilumab de\u2010escalation. While promising, this off\u2010label approach requires confirmation in prospective studies before routine implementation.<\/jats:p>","DOI":"10.1002\/ccr3.72457","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T09:13:47Z","timestamp":1778058827000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Less Can Be Enough: Sustained Remission of Pediatric Eosinophilic Esophagitis With Low\u2010Frequency Dupilumab"],"prefix":"10.1002","volume":"14","author":[{"given":"Giovanni","family":"Scatigna","sequence":"first","affiliation":[{"name":"NESMOS Department, Faculty of Medicine and Psychology Sapienza University of Rome, Pediatric Unit, Sant'Andrea University Hospital  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annarita","family":"Iadecola","sequence":"additional","affiliation":[{"name":"NESMOS Department, Faculty of Medicine and Psychology Sapienza University of Rome, Pediatric Unit, Sant'Andrea University Hospital  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Piersanti","sequence":"additional","affiliation":[{"name":"NESMOS Department, Faculty of Medicine and Psychology Sapienza University of Rome, Pediatric Unit, Sant'Andrea University Hospital  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Di Nardo","sequence":"additional","affiliation":[{"name":"NESMOS Department, Faculty of Medicine and Psychology Sapienza University of Rome, Pediatric Unit, Sant'Andrea University Hospital  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4000-6004","authenticated-orcid":false,"given":"Maurizio","family":"Mennini","sequence":"additional","affiliation":[{"name":"NESMOS Department, Faculty of Medicine and Psychology Sapienza University of Rome, Pediatric Unit, Sant'Andrea University 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