Eosinophilic esophagitis is a chronic immune condition where a type of white blood cell builds up in the esophagus, causing trouble swallowing and food getting stuck. It affects about 1 in 2,000 people and often starts in childhood. Until recently, the main treatment was swallowed steroids or elimination diets.
What's actually going on in research
Trials are testing biologic drugs that block specific immune signals driving inflammation, including dupilumab which gained FDA approval in 2022. Researchers are studying how to identify food triggers more precisely, whether treating early prevents long-term narrowing of the esophagus, and new ways to deliver steroids directly to the esophagus lining.
Biologic drugs
Dupilumab blocks interleukin signals and is now FDA-approved for eosinophilic esophagitis. Trials are testing other biologics that target different immune pathways to see if they work for people who don't respond to dupilumab.
Food trigger testing
Newer tests examine immune cells in the esophagus to predict which foods are causing inflammation. This may allow more targeted elimination diets than the current trial-and-error approach.
Preventing strictures
Studies are looking at whether treating eosinophilic esophagitis earlier and more aggressively prevents the esophagus from narrowing over time. This could reduce the need for repeated dilations.
What to know before you search
Eligibility typically depends on diagnosis confirmed by endoscopy showing elevated eosinophils, symptom severity, prior treatments tried, and whether food impaction has occurred.
What types of trials are currently open
- Biologic trials — Testing drugs like dupilumab and others that block immune signals. These are usually injections given every few weeks.
- Steroid delivery trials — Testing new forms of steroids that dissolve slowly in the esophagus, aiming to reduce inflammation with fewer side effects than swallowed pills.
- Diet intervention studies — Comparing different elimination diets or new methods to identify trigger foods. May involve endoscopies to measure response.
- Long-term outcome studies — Following people over years to understand how treatment affects esophageal narrowing, quality of life, and growth in children.
- Biomarker studies — Testing blood or tissue samples to find markers that predict who will respond to specific treatments.
Recently added Eosinophilic Esophagitis trials
Natural History of Eosinophilic Esophagitis in Adult and Pediatric Population
Eosinophilic esophagitis (EoE) is a Th2-mediated disease induced by ingestion of ambiental and alimentary allergens. Incidence of EoE is increasing in recent years. Young male subjects are more often affected by EoE. Esophageal eosinophilic infiltrate causes different symptoms of esophageal dysfunction (i.e. dysphagia, food impaction, chest pain, heartburn). In pediatric population symptoms are nonspecific (failure to thrive, vomiting) and more common to be misdiagnosed. Symptoms are commonly sporadic and underestimated by the patients. Therefore, specialistic evaluations are often delayed during the following months and years. Moreover, esophageal symptoms are often not investigated or associated with other diseases especially in pediatric population (i.e. gastroesophageal reflux disease). For this reason, diagnosis of EoE is often delayed. It is known from literature that diagnostic delay in EoE causes prolonged inflammation of the esophagus that may lead to esophageal fibrosis and stenosis with worsening of symptoms. Proton pump inhibitors (PPIs) and topical steroids are the first line medicines to induce EoE remission. Prolonged clinical remission is described in 60% of adult patients with PPIs. Recently orodispersible budesonide showed clinical remission after 1 year nearby in 90% of adult patients. Orodispersible budesonide is effective also in chidren with an efficacy in maintaining remission at lowest effective dosage after 60 weeks in around 78% of patients. Dysphagia Symptom Questionnaire (DSQ) is a validated tool used in order to measure clinical activity (dysphagia) in adult and pediatric patients with EoE. Italian version of the DSQ is not available in literature. Little is known in literature about the natural history of EoE patients, in particular about sustained clinical remission and appearance of complications (i.e. food impaction) during a prolonged follow-up period. Aim of our two-phase prospective study is to evaluate the clinical and endoscopic response at the current available therapies and the appearance of complications during a prolonged follow-up period in a cohort of adult and pediatric population.
Share your esophageal health data in a long-term registry
Digestive physiopathology is a branch of gastroenterology aiming to study patients with upper GI symptoms, mainly gastro-esophageal, potentially indicating the presence of Gastroesophageal Reflux Disease (GERD)/Barrett Esophagus (BE) or obstructive esophageal motility disorders (achalasia being the most relevant), but including also other primary motility disorders such as Esophgago-Gastric Junction Outflow Obstruction (EGJOO), Hypercontractile Esophagus (HE), Distal Esophageal Spasm (DES) and other minor disorders. Physiopathological testing encompasses High-Resolution Manometry (HRM), 24-H esophageal pH-impedance testing, Functional Lumen Imaging Probe (FLIP) assessment. All these tests are designed to provide a clear phenotyping of esophago-gastric disorders related to reflux or obstructive esophageal symptoms, either in naïve patients, as well as after foregut surgery (particularly anti-reflux surgery, achalasia/primary motility disorders treatment).
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