Researchers from Children’s Hospital of Philadelphia (CHOP) found that patients with the inflammatory disease eosinophilic esophagitis (EoE) who were treated with the monoclonal antibody dupilumab were able to safely reintroduce foods that would otherwise trigger their symptoms into their diet, with some patients able to reintroduce those foods earlier than others. The findings were recently published in the journal Clinical Gastroenterology and Hepatology.
EoE is a chronic allergic inflammatory disease of the esophagus, and children with this condition can experience nausea, regurgitation, vomiting, abdominal pain and a burning feeling like acid reflux. They may also have difficulty swallowing and gag frequently. EoE can sometimes be managed effectively by eliminating foods like milk, egg, soy, and wheat products that increase symptoms. However, avoiding those foods completely can be challenging and reduce quality of life.
Dupilumab is approved in the US and EU to treat patients with EoE aged 1 year and older weighing at least 15 kg (approximately 33 lbs) to help manage symptoms associated with the disease. Researchers wanted to know whether the therapy might also allow patients to add some of these trigger foods back into their diets.
The researchers conducted an open-label pilot study in which patients aged 6 to 25 years with EoE triggered by milk, egg, soy, or wheat were treated with dupilumab for three months, followed by standardized reintroduction of trigger foods at months 3, 6, and 9, while continuing on dupilumab treatment. The researchers studied symptoms and histology at key points over the course of a year. All patients had previously failed food trigger reintroduction on their prior EoE medications.
All of the 15 patients who completed the study were able to reintroduce at least one serving size of trigger foods by month 12 and eight patients were able to add foods every three months. No worsening of any clinical symptoms, histology or esophageal diameter was observed, and none of the patients experienced any serious treatment-related adverse events.
“These findings represent a significant step toward a more flexible approach in how patients with EoE can manage their disease,” said senior study author Jonathan Spergel, MD, PhD, Chief of the Allergy Program at CHOP. “Reintroducing trigger foods represents an opportunity to reduce anxiety and potentially improve quality of life for these patients and may serve as a simple next step to allow freedom of diet while ensuring continued disease control.”
This was a collaborative study sponsored by CHOP that received funding via charitable gifts from Alexandra and Greg Mondre and Eric and Sarah Lane to CHOP. Dupilumab was provided by Regeneron Pharmaceuticals Inc. and Sanofi.
Wolfset et al, “Efficacy of Dupilumab on Facilitated Food Reintroduction in Eosinophilic Esophagitis.” Clin Gastro Hepatol. Online September 30, 2025. DOI: 10.1016/j.cgh.2025.08.025.
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Researchers from Children’s Hospital of Philadelphia (CHOP) found that patients with the inflammatory disease eosinophilic esophagitis (EoE) who were treated with the monoclonal antibody dupilumab were able to safely reintroduce foods that would otherwise trigger their symptoms into their diet, with some patients able to reintroduce those foods earlier than others. The findings were recently published in the journal Clinical Gastroenterology and Hepatology.
EoE is a chronic allergic inflammatory disease of the esophagus, and children with this condition can experience nausea, regurgitation, vomiting, abdominal pain and a burning feeling like acid reflux. They may also have difficulty swallowing and gag frequently. EoE can sometimes be managed effectively by eliminating foods like milk, egg, soy, and wheat products that increase symptoms. However, avoiding those foods completely can be challenging and reduce quality of life.
Dupilumab is approved in the US and EU to treat patients with EoE aged 1 year and older weighing at least 15 kg (approximately 33 lbs) to help manage symptoms associated with the disease. Researchers wanted to know whether the therapy might also allow patients to add some of these trigger foods back into their diets.
The researchers conducted an open-label pilot study in which patients aged 6 to 25 years with EoE triggered by milk, egg, soy, or wheat were treated with dupilumab for three months, followed by standardized reintroduction of trigger foods at months 3, 6, and 9, while continuing on dupilumab treatment. The researchers studied symptoms and histology at key points over the course of a year. All patients had previously failed food trigger reintroduction on their prior EoE medications.
All of the 15 patients who completed the study were able to reintroduce at least one serving size of trigger foods by month 12 and eight patients were able to add foods every three months. No worsening of any clinical symptoms, histology or esophageal diameter was observed, and none of the patients experienced any serious treatment-related adverse events.
“These findings represent a significant step toward a more flexible approach in how patients with EoE can manage their disease,” said senior study author Jonathan Spergel, MD, PhD, Chief of the Allergy Program at CHOP. “Reintroducing trigger foods represents an opportunity to reduce anxiety and potentially improve quality of life for these patients and may serve as a simple next step to allow freedom of diet while ensuring continued disease control.”
This was a collaborative study sponsored by CHOP that received funding via charitable gifts from Alexandra and Greg Mondre and Eric and Sarah Lane to CHOP. Dupilumab was provided by Regeneron Pharmaceuticals Inc. and Sanofi.
Wolfset et al, “Efficacy of Dupilumab on Facilitated Food Reintroduction in Eosinophilic Esophagitis.” Clin Gastro Hepatol. Online September 30, 2025. DOI: 10.1016/j.cgh.2025.08.025.
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