Induction and Maintenance Therapies in EoE

In this episode, ‘Induction and Maintenance Therapies in EoE,’ the panelists explore how available therapies fit across the induction and maintenance phases of eosinophilic esophagitis care. The expert faculty discuss the goals of induction therapy, including controlling inflammation and assessing histologic response, and emphasize the importance of repeat endoscopy and biopsy rather than relying on symptom improvement alone to determine treatment response.

The panel reviews how proton pump inhibitors, swallowed topical corticosteroids, dietary therapy, and biologics can be incorporated into EoE management. They discuss considerations for transitioning from induction to maintenance therapy after achieving remission, including whether treatment can be de-escalated while maintaining disease control. Because EoE is a chronic disease, the panelists emphasize that effective therapy generally needs to be continued long term to reduce the risk of disease recurrence.

The expert faculty also examine the importance of reassessing disease activity when treatment is modified. They discuss how repeat endoscopy and histologic evaluation can help confirm that remission is maintained following changes in dose or therapeutic approach. Dietary therapy is considered within the context of patient motivation, nutritional considerations, and the need to identify potential food triggers, while biologic therapy provides another option for patients based on their clinical needs and response to other approaches. Throughout the episode, the panel underscores the importance of shared decision-making and flexibility over the course of treatment. As patients’ preferences, lifestyles, and needs evolve, treatment may also change, provided that disease control is appropriately reassessed and maintained.

The next episode in this series, ‘Personalizing Treatment and Reassessment in EoE,’ features the panelists examining how patient preferences, lifestyle, comorbidities, and practical considerations influence individualized treatment selection. They also discuss how treatment choice and clinical circumstances guide the timing of endoscopic reassessment and evaluation of treatment response.