EoE Therapy: CGH | September 2026 | Network Meta-analysis

What Did the Study Find?

This network meta-analysis of 13 randomised controlled trials compared biologics and swallowed topical corticosteroids for eosinophilic esophagitis (EoE), assessing clinical, histologic, and endoscopic outcomes.

Dupilumab 300 mg ranked highest for dysphagia improvement at 12 and 24 weeks.

Budesonide oral suspension (BOS) 2 mg improved dysphagia at 12 weeks.

At 48 weeks, budesonide orodispersible tablets (BOT) showed strong symptomatic efficacy.

Nearly all therapies achieved histologic remission, with the exception of etrasimod.

Importantly, histologic improvement did not consistently translate into symptomatic benefit.

Comparative long-term and safety data remain limited, with few direct biologic-versus-steroid trials.

Why Does It Matter?

The findings reinforce that histology alone should not define treatment success in EoE. Dysphagia, endoscopic response, and histologic activity provide complementary information.

GastroAGI Takeaway

Dupilumab and swallowed topical budesonide currently have the strongest multidomain efficacy signals. However, network rankings should not be interpreted as proof of superiority. Until robust head-to-head trials are available, EoE therapy should be individualized using symptoms, endoscopy, histology, safety,