Along with medication, EoE sometimes is managed with an elimination diet, which involves removing common food allergens — typically, dairy, eggs, soy, and wheat — from the diet and then adding them back in one at a time to determine which, if any, trigger symptoms and should be avoided. “We have years of experience [treating eosinophilic esophagitis] with those therapies, and we know they can work,” says Cash. “Just because [dupilumab] is the only FDA-approved therapy doesn’t mean that it moves straight to the top of the line.” That said, if you have another allergic condition, such as asthma or atopic dermatitis, you may be a good candidate for dupilumab, says Cash, since it blocks IL-4 and IL-13, the cytokines that play a role in triggering allergic reactions.
