Recent Advances in the Treatment of Eosinophilic Esophagitis

Abstract

Eosinophilic esophagitis is an increasingly common inflammatory allergic disease of the esophagus characterized by esophageal eosinophilia and symptoms of esophageal dysfunction. The therapeutic landscape has rapidly evolved for this emerging type 2 inflammatory disorder. We review traditional therapies including updates and expert opinions in addition to promising therapies on the horizon and the history of therapies that failed to meet end points and highlight knowledge gaps for future investigations.

Keywords: Allergy; Eosinophilic esophagitis; Treatment; Updates.

Figure 1.

Proposed treatment algorithm. *Dupilumab has been suggested for the following groups of patients⁸⁷: Patients who also have asthma, atopic dermatitis, or chronic rhinosinusitis with polyposis meeting criteria for biologic therapy; Patients with strictures; Patients with failure to thrive, weight loss, or growth impairment due to EoE; Patients who require elemental formula for 50+% of their daily caloric intake due to EoE; Patients with severe inflammation requiring frequent oral glucocorticoids; Patients who have failed first line (topical corticosteroid, PPI, diet) therapy; Patients who have experienced adverse effects from other therapies, eos/hpf, Eosinophils per high-power field.