Advancing EoE Care Through Innovation, Collaboration, and Real-World Impact

In 2024, the U.S. Food and Drug Administration (FDA) approved two drugs for patients with eosinophilic esophagitis (EoE)—Dupixent® (dupilumab) in children as young as 1 year of age and Eohilia™ (budesonide oral suspension) in children 11 years and older. Thanks to discoveries from the Cincinnati Center for Eosinophilic Disorders (CCED), researchers now understand more of the basic science behind these drugs’ novel mechanisms of action.

The CCED is one of the first and largest eosinophilic disease programs in the world. As a dedicated research hub, the center plays a pivotal role in several multicenter clinical trials, including the two that resulted in these FDA wins. The seamless interaction between clinical care and research that the CCED fosters helps drive the basic understanding of how these diseases work and keeps the focus on patient and family needs to improve their care.

“We know that a lot of what we’ve done for patients for years works,” explains Vince Mukkada, MD, site principal investigator and author on the budesonide studies. “But we want to push the envelope forward and ask, ‘Are there new approaches that might be novel or offer real advantages to our patients?’ We are constantly trying to advance the field and improve what we do.”

Dupilumab Simplifies Treatment Regimen for Allergies

In 2022, dupilumab became the first drug approved for children and adults 12 and older with EoE, a rare food allergy that affects how the esophagus functions. By January 2024, the FDA approved it as a treatment in kids as young as 1 year of age. Dupilumab is a biologic drug that focuses on the severe inflammation from EoE, as well as other allergic conditions.

“What it really offers is one medication to treat multiple atopic diseases,” Mukkada says. “Particularly for many of our patients who have multiple allergic diseases, including eosinophilic esophagitis, asthma, eczema and allergic rhinitis, dupilumab offers a major step forward compared to previous treatments that have been very focused on the esophagus.”

Currently, over 300 patients at Cincinnati Children’s are taking dupilumab—one of the largest groups of patients anywhere.

From this large set of real-world experience, the CCED continues to evaluate how dupilumab functions and how best to use it to care for patients.

Eohilia Standardizes Dosage and Delivery

Along with dupilumab, 2024 saw the approval of Eohilia, the first oral medication for EoE treatment. As a preformulated budesonide solution, Eohilia simplifies the drug regimen significantly. It eliminates the need for patients to correctly mix the medication for themselves.

“By standardizing the dosage and delivery mechanism, we can better assess whether the medication is helpful,” Mukkada says. “This kind of targeted therapy that’s simple and effective can make life much easier on patients.”

Though still in its infancy, Eohilia is the first oral formulation designed specifically to coat and treat the esophagus. The CCED continues to analyze the drug’s effectiveness, with involvement in another clinical trial to test Eohilia in even younger patients. Currently, the drug is approved for patients 11 years and older.

The Path Forward for Eosinophilic Disorder Research

The CCED leads the way in eosinophilic disorder research that advances science, patient care and patient outcomes. For Mukkada, the CCED at Cincinnati Children’s is at an advantage when it comes to research because:

• Internal collaboration means sharing innovative ideas—fast: The CCED is a multidisciplinary partnership between the divisions of Allergy and Immunology, Gastroenterology, Hepatology and Nutrition, and Pathology. Thinking through problems patients face with several different lenses means better, more refined solutions.


• External collaboration results in rapid advancements: The CCED is part of the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR), an NIH effort with 17 sites. As the central CEGIR site since the beginning, the CCED has helped bring together the EoE community and make research advancements come to fruition much more quickly.


• The next generation of EoE researchers is here: For the past 10 years, the CCED has had a continuous stream of gastroenterology fellows who’ve been involved in EoE research. They receive training to help them not only clinically but also academically and in research, which keeps the field moving forward.

The center is currently involved in four therapeutic trials related to EoE, with several others on the horizon—supporting patients with EoE and other eosinophilic disorders.

“For some patients, dupilumab is the answer,” says Mukkada. “For others, they’re doing great on their current regimen, but if we could simplify it, standardize it and make it more palatable, we can improve their quality of life and how they manage their chronic illness—which is really our overarching goal.”

(Published October 2024)

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