The identification of patients with EoE is complex and available treatments have long been suboptimal. Symptoms associated with EoE, such as dysphagia, regurgitation, and chest pain are heterogenous and identifying those who would benefit from esophagogastroduodenoscopy (EGD) requires the recognition of additional risk. Approximately 12% to 23% of patients undergoing EGD for dysphagia are diagnosed with EoE. Compounding this reality, the needs of individuals diagnosed with EoE have historically been unmet. Until recently, the management strategy for patients with EoE have included the use of agents off-label that have inadequate efficacy, such as proton pump inhibitors (PPI), swallowed topical corticosteroids, and the elimination of food allergens from the diet.

Emerging agents targeting the inflammatory pathways that underpin EoE development have shown promise in randomized clinical trials and are helping to tease apart its complex pathophysiology. EoE is emerging as a disease driven largely by T-helper 2 cell (Th2)-mediated inflammatory processes, and guideline recommendations published in 2020 by the American Gastroenterological Association and the Joint Task Force on Allergy-Immunology Practice Parameters already require an update to its treatment paradigm based on the latest clinical trial results and approval of the EoE being added to the indication of dupilumab by the Food and Drug Administration (FDA).