Early treatment for eosinophilic esophagitis may lower children's asthma risk

by American College of Allergy, Asthma, and Immunology

edited by Sadie Harley, reviewed by Andrew Zinin

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Young children treated for eosinophilic esophagitis (EoE) with dupilumab were less likely to develop asthma in the future compared with children who received a different treatment. The findings come from a new study presented at the American College of Allergy, Asthma and Immunology (ACAAI) 2026 Annual Scientific Meeting. The study also appears in Annals of Allergy Asthma & Immunology.

EoE is an allergic disease affecting the esophagus, the tube that carries food from the mouth to the stomach. In children with EoE, allergic swelling in the esophagus can make eating difficult. Some children refuse food, throw up or don't grow as well as they should.

Allergic diseases often show up one after another as children grow. A child might have eczema first, then food allergies and later asthma. Allergists sometimes call this the "allergic march." Certain forms of EoE and asthma are both part of it, and the same kind of messages from the body that trigger allergy reactions drives both conditions.

That raised a question: could early treatment of the shared instructions the body's cells send to each other help stop the march before asthma starts?

"Children with EoE are at higher risk for other allergic diseases, including asthma," said immunologist Kayla Steinberger, M.D., Ph.D., author of the study and ACAAI member.

"These results suggest that calming messages that trigger allergy reactions early in life might do more than help a child swallow. It may also lower the chance that asthma will be the next allergic condition to develop. We need more research to know for sure."

Steinberger used global health records from medical centers, covering the years 2016 through early 2026. The study looked at children ages 6 and younger who had EoE but did not have asthma. The children received one of two treatments:

• Dupilumab, a medicine given as a shot. It blocks signals in the body that cause allergic inflammation.
• Budesonide, a steroid medicine that is swallowed so it can coat the esophagus.

The study compared 344 children who took dupilumab with 401 children who took budesonide. The two groups were matched to be alike in age, sex and whether they had eczema.

The results showed:

• About 11 out of every 100 children who took dupilumab later got asthma.
• About 16 out of every 100 children who took budesonide later got asthma.
• Children who took dupilumab were about one-third less likely to develop asthma.
• Children who took dupilumab also had about half as many asthma diagnoses during the study.

Although the study shows a link, it does not prove that dupilumab prevents asthma. The next step is conducting studies that follow children over time to test this directly. For now, parents of children with EoE should talk with a board-certified allergist about treatment choices and watch for signs of asthma, such as coughing, wheezing or trouble breathing.

More information

Early Dupilumab Treatment for Pediatric Eosinophilic Esophagitis Is Associated With Reduced Incident Asthma, Annals of Allergy Asthma & Immunology (2026).

Key medical concepts

AsthmaEosinophilic EsophagitisdupilumabBudesonide

Clinical categories

Allergy and immunologyChildren's healthPediatricsPulmonary medicineCommon illnesses & Prevention Provided by American College of Allergy, Asthma, and Immunology Who's behind this story?

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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