The evolving therapeutic landscape for eosinophilic esophagitis (EoE) highlights dupilumab as the cornerstone biologic treatment, with a promising pipeline of emerging agents.
Dupilumab remains the only approved biologic for EoE (FDA approval in 2022, with expansions to younger patients), effectively targeting IL-4/IL-13 pathways to reduce inflammation, improve histology, and alleviate symptoms like dysphagia.
Ongoing developments include:
Cendakimab (an anti-IL-13 monoclonal antibody) has shown strong Phase 3 results, with significant and sustained improvements in symptoms, eosinophil counts, and endoscopic features through 48 weeks.
Tezepelumab (anti-TSLP) continues in its Phase 3 CROSSING trial (expected completion around 2027), building on earlier promising data.
Vonoprazan (a potassium-competitive acid blocker) is advancing into Phase 2 studies for EoE, offering potential as an enhanced acid suppression option beyond traditional PPIs.
Topical corticosteroids (e.g., budesonide formulations) and PPIs stay essential first-line therapies, while broader reviews emphasize precision approaches, comprehensive endpoints, and addressing symptom-histology discordance.
The field is progressing toward more targeted, disease-modifying options to prevent complications like fibrosis.