Identifying patients with eosinophilic esophagitis (EoE) is complex. Symptoms such as dysphagia, regurgitation, and chest pain are heterogenous and indicative of numerous other conditions. A definitive diagnosis requires an esophagogastroduodenoscopy (EGD), which carries its own risks.
Once diagnosed, the needs of those with EoE remain unmet, with suboptimal treatments that treat the symptoms, but not the underlying disease. These include off-label treatments, such as such as proton pump inhibitors (PPI), swallowed topical corticosteroids, and special diets.
We now understand that EoE is a disease driven largely by T-helper 2 cell (Th2)-mediated inflammatory processes and emerging agents targeting these inflammatory pathways have shown promise in randomized clinical trials, including the FDA-approved drug, dupilumab, and several other investigational compounds.
This web site provides an in-depth review of the pathophysiology of EoE and current and emerging treatments.
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).
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This activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc. and Sanofi.
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