Personalizing Treatment and Reassessment in EoE

In this episode, ‘Personalizing Treatment and Reassessment in EoE,’ the expert advanced practice providers explore how patient-specific and practical considerations can shape treatment selection for eosinophilic esophagitis. The panelists emphasize a patient-driven approach to care, highlighting the importance of understanding each patient’s circumstances and preferences when selecting a treatment that is both clinically appropriate and feasible over time.

The expert faculty discuss how factors such as difficulty swallowing pills, existing dietary restrictions, route of administration, needle aversion, lifestyle, and comorbid atopic conditions can influence treatment decisions. They also highlight shared decision-making as an important component of EoE management, particularly given the chronic nature of the disease and the need for sustained patient engagement with therapy. As patients’ circumstances and preferences evolve, the panel notes that treatment strategies may also need to evolve.

The discussion then turns to the initial treatment course and how clinicians determine when to reassess disease activity. The panelists describe how the timing of repeat endoscopy may vary depending on the selected treatment and emphasize the importance of evaluating histologic response rather than relying on symptoms alone. They also consider circumstances that may warrant earlier evaluation, including recurrent symptoms or the need to manage an esophageal stricture.

Finally, the panel discusses practical barriers to timely endoscopic reassessment and the potential role of transnasal endoscopy as an emerging approach to obtaining biopsies without sedation. Together, these considerations reinforce the importance of aligning treatment and reassessment strategies with both disease characteristics and individual patient needs.

Our next episode, ‘Long-Term Budesonide Oral Suspension Data in EoE,’ examines long-term efficacy, safety, and tolerability findings with BOS and how the study design reflects aspects of clinical practice. The panelists discuss how these data may inform patient counseling, ongoing monitoring, and decisions surrounding long-term therapy.