Monoclonal antibodies (a type of biologic therapy) also target inflammation in the esophagus and can improve EoE symptoms like difficulty swallowing. “Biologics target specific inflammatory pathways driving EoE, offering a more tailored and systemic approach when traditional options aren’t enough,” says Dr. Nahar.
The only biologic therapy approved by the U.S. Food and Drug Administration to treat EoE is dupilumab (Dupixent), which is given by injection, although others are being tested. “Clinical studies show that dupilumab can improve swallowing, reduce inflammation, and even help heal narrowing in the esophagus after just a few months of treatment,” says Gonzalez.
Because it works in a targeted way, dupilumab has proved to be safe and well-tolerated, says Gonzalez. “The most common side effects are mild injection-site reactions, such as redness or tenderness.”
Some studies suggest providers try localized treatment options before offering dupilumab, which affects the whole body. But if you have EoE alongside other inflammatory conditions like asthma or atopic dermatitis, you may be started on this therapy first, since it can also treat these at the same time.

