Eosinophilic Esophagitis Clinical Trials and Research: What’s Being Discovered?

For many years, people living with eosinophilic esophagitis (EoE) had limited treatment options. Today, new research and clinical trials are changing that, leading to the first drug approved by the U.S. Food and Drug Administration (FDA) specifically for EoE.

Over the past decade, doctors and researchers have learned much more about how EoE develops, how to diagnose it, and which treatments work best. Keeping up to date on the latest eosinophilic esophagitis news can help you stay informed about new treatment options and discoveries. This can also prepare you to talk with your doctor about whether these advances could help you or your child with EoE.

Keep reading to learn what’s new in EoE research and clinical trials.

Why Is Eosinophilic Esophagitis Research Important?

EoE causes symptoms such as strictures (narrowing of the esophagus), food impaction (food getting stuck in the throat), dysphagia (trouble swallowing), and abdominal or chest pain. Studies also show that EoE can strongly affect mental health, which is why more research is needed to find treatments that improve quality of life.

The number of people diagnosed with EoE has increased rapidly in recent years. This is likely due to a mix of environmental and genetic factors, as well as increased awareness and better diagnosis by healthcare providers. Researchers are studying possible causes and risk factors to better understand why EoE is becoming more common.

Understanding EoE Causes and Risk Factors

People with conditions including atopic dermatitis and other types of eczema, allergies, and asthma are more likely to develop EoE. A 2025 study also found a link between EoE and inflammatory bowel disease (IBD), a gastrointestinal disease that causes abdominal pain, bloody stools, and diarrhea. Although more research is needed to understand this connection, it supports the idea that problems with the immune system may play a role in both conditions.

Researchers are also investigating theories that suggest a link between EoE risk and certain environmental exposures, such as:

• Being born by cesarean section
• Using antibiotics or acid-suppressing medications in infancy
• Being exposed to allergens or air and water pollution
• Living in a densely populated area

Although many studies have looked at these connections, researchers don’t know exactly what triggers EoE in each person. Ongoing research aims to identify which exposures matter most and whether reducing them could lower risk and improve care.

Assessing EoE Symptoms

As researchers learn more about EoE, one area of focus involves understanding how severe the condition can get and what factors can make it worse. A recent study looked at symptom severity in about 400 adolescents and adults with EoE. The findings showed that severe EoE is uncommon — fewer than 10 percent of participants had severe symptoms. Most people had mild or moderate EoE symptoms.

Severe EoE symptoms include:

• Food impaction
• Regurgitation (food or liquid coming back up into the mouth or throat)
• Weight loss

Having more moderate or severe EoE is linked to a longer delay in diagnosis and more treatment failures. This research highlights the importance of early diagnosis and tailoring treatment to symptom severity.

Advances in Diagnosing Eosinophilic Esophagitis

Getting an EoE diagnosis requires an endoscopy — a procedure in which a thin, flexible tube with a camera is passed through the mouth to look at the esophagus and collect tissue samples (called a biopsy). Doctors examine these samples under a microscope to count the number of eosinophils, a type of white blood cell, to confirm an EoE diagnosis.

However, these tests are time-consuming, uncomfortable, and costly. That’s why researchers are exploring new, less invasive methods to help diagnose EoE.

One promising method involves biomarkers — substances in the body that can signal the presence or severity of a disease. The eosinophil count in a biopsy sample is an example of a key biomarker for EoE. However, researchers are looking into how to collect biomarkers from the esophagus without an endoscopic procedure. They’re exploring whether biomarkers in blood, urine, saliva, or breath could help diagnose and monitor EoE.

New Treatments for Eosinophilic Esophagitis

Traditional EoE treatments focus on easing and decreasing the number of eosinophils in the esophagus, rather than targeting the cause of inflammation. Common first treatments include:

• Proton pump inhibitors (PPIs)
• Swallowed topical corticosteroids (such as budesonide oral suspension, approved in 2024 for people 11 and older with EoE)
• Dietary changes, such as an elimination diet

Biologic therapies are a newer type of medication used to treat EoE. These protein-based drugs are made from living cells and work by targeting parts of the immune system that cause EoE inflammation. Biologics are designed to block the underlying pathways that drive EoE.

Dupilumab

Dupilumab (Dupixent) is a biologic therapy first approved by the FDA in 2022 to treat EoE in people 12 and older. In 2024, the FDA expanded the approval to include children 1 year and older. The American College of Gastroenterology recommends dupilumab for adults and children who don’t respond to PPI therapy.

Dupilumab uses monoclonal antibodies (lab-made antibodies) that act on the immune system to dampen inflammation. This drug works by blocking certain proteins called cytokines that trigger inflammation. This helps reduce both EoE symptoms and eosinophil levels in the esophagus.

Researchers are also studying dupilumab to see if it can help treat other allergy-related conditions that often occur with EoE, such as asthma, food allergies, and eczema.

Investigational EoE Treatments

Although dupilumab was the first drug approved specifically for EoE, researchers are exploring additional options.

Biologics Under Development

Several other biologic therapies are being studied in clinical trials for people with EoE.

Cendakimab is a biologic that may help reduce tissue damage in the esophagus. Early clinical trials found that this medication significantly lowered eosinophil count. Because of these promising results, larger trials are underway.

The biologics mepolizumab, reslizumab, and benralizumab work by blocking a cytokine that regulates how eosinophils grow and survive. Clinical trials have found that these drugs reduce eosinophil counts but don’t significantly improve symptoms. However, researchers believe that similar therapies may help certain people with EoE.

Other biologics in development target different inflammation pathways, with the goal of expanding future treatment options for EoE.

Probiotics

Probiotics are beneficial microbes that you take as supplements. Researchers are increasingly studying the gut microbiome (the mix of microorganisms in the digestive tract) and how it might affect EoE. Current treatments, including dietary changes, corticosteroids, and PPIs, can change the balance of microbes in the gut, which might influence EoE.

Early studies in animals suggest that probiotics could support these treatments and help manage EoE, but more research is needed to confirm their effectiveness in people.

What Is the Future of Treatment for EoE?

Healthcare providers and researchers are working on new treatments for EoE. As they learn more about how EoE develops and the immune processes involved, they’ll be better able to find drugs that target these processes.

In some cases, this may mean expanding how current therapies are used. Right now, dupilumab is recommended only for people who haven’t responded to other treatments, like PPIs, or have other diseases that can also be treated with dupilumab. Future research may focus on whether starting dupilumab earlier could improve symptoms and quality of life.

Talk to Your Healthcare Provider About New Treatments

If you’re interested in trying a newer treatment like dupilumab or want to join a clinical trial for EoE, talk with your healthcare provider. They’ll likely be up to date on current studies on EoE and other gastrointestinal disorders that you might qualify for. You can also visit ClinicalTrials.gov to search for EoE trials that are actively enrolling participants.

Join the Conversation

On myEoEcenter, people share their experiences with eosinophilic esophagitis, get advice, and find support from others who understand.

Have you considered participating in a clinical trial testing a new treatment for EoE? Let others know in the comments below.