Eosinophilic esophagitis is a chronic immune condition where white blood cells called eosinophils build up in the esophagus, causing inflammation, difficulty swallowing, and food getting stuck. About 1 in 2,000 people have it, with diagnosis increasing over the past 20 years. Treatment includes swallowed steroids, diet changes to remove trigger foods, and a newer biologic drug that targets the immune pathway driving inflammation.
What's actually going on in research
Trials are testing biologics that block different parts of the immune response, including drugs already approved for asthma and atopic dermatitis. Researchers are also studying endoscopic dilation techniques, better ways to identify trigger foods, and whether early treatment prevents long-term scarring of the esophagus. Dupilumab was FDA-approved for eosinophilic esophagitis in 2022.
Anti-IL biologics
Dupilumab blocks IL-4 and IL-13, immune signals that drive eosinophil buildup, and was the first biologic approved for this condition. Other IL-13 blockers and IL-5 inhibitors are now in trials to see if they work as well or better.
Food trigger testing
Studies are testing skin patch tests and blood tests to predict which foods cause inflammation, aiming to replace elimination diets that require removing six or more food groups for weeks. Faster identification could make diet therapy more practical.
Esophageal remodeling
Researchers are studying whether treating inflammation early prevents permanent narrowing and stiffness of the esophagus. Trials are also testing whether biologics can reverse existing scarring.
What to know before you search
Eligibility typically depends on eosinophil count on recent endoscopy, symptoms like trouble swallowing, age, and whether swallowed steroids have already been tried.
What types of trials are currently open
- Biologic trials — Testing injectable drugs that block specific immune pathways, typically given every few weeks. Most compare the biologic to placebo in people not controlled on swallowed steroids.
- Dietary intervention studies — Testing food elimination approaches, often using endoscopy to measure whether removing certain foods reduces eosinophils.
- Swallowed steroid trials — Testing different doses, formulations, or delivery methods of topical steroids that coat the esophagus.
- Dilation studies — Testing endoscopic stretching techniques to widen the esophagus in people with narrowing from chronic inflammation.
- Biomarker studies — Following people over time to learn which blood tests, genetic markers, or endoscopy findings predict who will respond to treatment.
Recently added Eosinophilic Esophagitis trials
Receive esophageal function measurements in different body positions
This is a prospective, single-center, crossover study comparing EndoFLIP measurements obtained in two patient positions, supine and left lateral decubitus, in pediatric and young adult patients. The Endoluminal Functional Lumen Imaging Probe (EndoFLIP) is an FDA-approved device for patients aged 5 and older that utilizes high-resolution impedance planimetry and volume-controlled distension to assess esophagogastric junction function. Currently, no standardized positioning protocol exists, and proceduralists perform EndoFLIP based on individual preference, either supine or left lateral decubitus. This variability may introduce measurement inconsistencies, particularly when comparing preoperative and postoperative assessments performed in different positions.
Share your dietary and health information as you follow elimination diets
This prospective observational cohort study aims to evaluate clinical and histologic outcomes of elimination diets in children aged 2-17 years with eosinophilic gastrointestinal disorders (EGIDs). The type of elimination diet will be determined by the treating physician as part of routine clinical care according to each patient's clinical characteristics. The study will not assign participants to a specific dietary treatment. Clinical symptoms, histologic findings, growth parameters, and nutritional outcomes will be prospectively recorded. Follow-up endoscopy and biopsies performed as part of routine clinical care will be used to assess histologic response. Food reintroduction and disease recurrence will also be evaluated during follow-up.
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