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Position Paper on the Treatment of Eosinophilic Esophagitis With Dupilumab

Tomás-Pérez M1,2,3, Domenech-Witek J3,4, Ávila-Castellano MR3,5,6, Carballas-Vázquez C3,7, Vásquez-Bautista AA3,8, Jover-Cerdá V3,9, González-Mendiola R3,10

1Allergy Department, Hospital Universitario La Paz, Madrid, Spain
2Instituto de Investigación (IDiPAZ), Madrid, Spain
3SEAIC Food Committee, Eosinophilic Esophagitis Group, Spain
4Allergy Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
5Allergy Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
6Unidad de Gestión Clínica Alergología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
7Allergy Department, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
8Allergy Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
9Allergy Department, Hospital General Universitario, Elda, Alicante, Spain
10Allergy Department, Hospital Central Cruz Roja, Madrid, Spain

J Investig Allergol Clin Immunol 2025; Vol. 35(3)
doi: 10.18176/jiaci.1038

Eosinophilic esophagitis (EoE) is a chronic allergic condition affecting the esophagus and driven by food antigens. Many individuals diagnosed with EoE have other allergic conditions, such as food allergy, asthma, allergic rhinitis, and atopic dermatitis. The clinical goals of therapy in EoE include symptomatic, histologic, and endoscopic remission. The current paradigm for the treatment of EoE in Spain includes proton pump inhibitors, swallowed topical corticosteroids, and food elimination diets. These treatments have proven very effective in clinical studies. In April 2024, the Spanish Agency for Medicines and Medical Products approved dupilumab as the second drug for the treatment of EoE, thus adding this biologic to the therapeutic arsenal in EoE.
The present review includes a positioning statement by the authors, all of whom are members of the Spanish Society of Allergy and Clinical Immunology Food-EoE Working Group.

Key words: Eosinophilic esophagitis, Dupilumab, Food allergy, Outcomes, Atopy, Positioning