Eosinophilic esophagitis (EoE): Current developments in therapy

Knowledge about EOE has expanded and innovations in the therapeutic area are available. EOE is a TH2-mediated disease that, in the context of an esophageal barrier disorder, results in eosinophilic inflammation of the esophagus. In addition to the chronic persistent inflammation, which leads to dysphagia in those affected, this can result in structural remodeling with the appearance of strictures and other functional disorders. In particular, the occurrence of strictures should be avoided, as these are irreversible long-term damage as a result of chronic inflammation. Food allergens can play a role as individual trigger factors in EOE. Therefore, the 6 -food elimination diet was developed and was shown to be somewhat effective in clinical studies. However, the impact of therapeutic measures in the context of nutrition with regard to quality of life must also be taken into account. Recently, dupilumab was approved for the treatment of eosinophilic esophagitis at the European level. The pivotal registration study showed that a biweekly administration of dupilumab led to histological remission of the inflammation in 60% of those affected. The GBA recently did not find any additional benefit for the treatment of EOE, although from an allergological perspective a positive assessment is desirable as this is a modern and safe therapy option for affected patients.