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Current and emerging therapies for eosinophilic esophagitis

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Background:

Eosinophilic esophagitis (EoE) is a Type-2 chronic inflammatory food antigen‐driven disease of the esophagus, characterized by eosinophilic predominant inflammation and a constellation of symptoms. The incidence and prevalence of EoE has increased over the past 2 decades. There is an unmet need for approved less burdensome treatment options.

Objective:

To describe the underlying pathophysiology and diagnosis of EoE and discuss the currently available treatment options. We also aim to review the new and emerging therapies for EoE.

Methods:

A search of a medical literature data base was performed for articles that discuss treatment for EoE.

Results:

A comparison of current therapies showed that dietary elimination, swallowed topical corticosteroids, and proton-pump inhibitor therapy are all effective for different populations. Emerging therapies that were reviewed include new topical corticosteroids and biologics directed against Type 2 inflammation.

Conclusion:

EoE is a chronic inflammatory disorder that can be debilitating, with long-term sequelae. There are no current approved therapies in the United States. Numerous new treatments are on the horizon. Increasing amounts of data are helping to tailor treatment for each patient. Ultimately, shared decision-making is the best approach to guide treatment choices with patients to manage the ever-increasing burden of this disease.

Keywords: Biologic; Corticosteroid; Dietary; Eosinophil; Eosinophilic esophagitis (EoE); Interleukin-13 (IL-13); Interleukin-4 (IL-4); Interleukin-5 (IL-5); Proton Pump Inhibitor (PPI); Th2 inflammation

Document Type: Research Article

Affiliations: 1: From the Department of Medicine, Rutgers Robert Wood Johnson Medical Center, Allergy Partners of New Jersey, Ocean, New Jersey; 2: Department of Medicine, Jersey Shore University Medical Center, Allergy Partners of New Jersey, Ocean, New Jersey; 3: Department of Medicine, Hackensack Meridian School of Medicine, Riverview Medical Center, Red Bank Gastroenterology, Allied Digestive Health, Red Bank, New Jersey; and 4: Department of Medicine, Monmouth Medical Center, Rutgers Robert Wood Johnson Medical Center, Long Branch, New Jersey

Publication date: May 1, 2022

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  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

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    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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