Evolving Biologic Evidence in EoE

In this episode, ‘Evolving Biologic Evidence in EoE,’ the expert advanced practice providers explore emerging evidence for dupilumab and how recent clinical trial findings may inform the assessment and treatment of patients with eosinophilic esophagitis. The panel first examines findings from the REMODEL study, which demonstrated improvements in esophageal distensibility with dupilumab, particularly among patients with a narrow baseline esophageal caliber.

The expert faculty discuss why histologic response alone may not fully capture disease activity in patients with fibrostenotic EoE. They consider the potential value of complementary assessments, such as EndoFLIP, for evaluating esophageal distensibility and identifying structural abnormalities that may contribute to persistent symptoms despite histologic improvement. The panelists also examine how evidence of improved distensibility may influence treatment selection, including whether patients presenting with severe fibrostenotic disease or a narrow-caliber esophagus could warrant earlier consideration of biologic therapy.

The discussion then shifts to pediatric evidence from the EoE KIDS trial, in which dupilumab demonstrated significantly higher rates of histologic remission than placebo among children aged 1 to 11 years. Although several panelists primarily treat adults, they discuss how pediatric efficacy and safety data can inform conversations with adult patients who may have concerns about biologic therapy. The panel also highlights the value of translating clinical trial findings into understandable information that can support patient education and shared decision-making. Together, the REMODEL and EoE KIDS findings illustrate how expanding evidence across disease phenotypes and age groups may continue to shape the role of biologic therapy in EoE.

The next episode in this series, ’Defining Treatment Success and Disease Control in EoE Care,’ features the panelists discussing how patient-defined goals, symptom improvement, endoscopic findings, and histologic response contribute to evaluating treatment success. They also explore why discordance among these measures makes a multidimensional assessment of disease control important in EoE.