November 12, 2026
Study finds young children treated with dupilumab for EoE were less likely to develop asthma later
PHOENIX (Nov. 12, 2026) – Young children treated for eosinophilic esophagitis (EoE) with dupilumab (a biologic medication) were less likely to develop asthma in the future compared with children who received a different treatment. The findings come from a new study being presented at the American College of Allergy, Asthma and Immunology (ACAAI) 2026 Annual Scientific Meeting.
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, MD, PhD, 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.”
Dr. Steinberger used global health records from medical centers, covering the years 2016 through early 2026. The study looked at children aged 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 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. To find an allergist near you, visit AllergyandAsthmaRelief.org.
Abstract Title: Early Dupilumab Treatment for Pediatric Eosinophilic Esophagitis Is Associated With Reduced Incident Asthma
Presenter: Kayla Steinberger, MD, PhD
For more information about diagnosis and treatment of EoE, or to find an allergist in your area, visit AllergyandAsthmaRelief.org. The ACAAI Annual Scientific Meeting is Nov. 12-16. For more news and research from the ACAAI Scientific Meeting, go to our newsroom and follow the conversation on X/Twitter #ACAAI26.
About ACAAI
The American College of Allergy, Asthma & Immunology (ACAAI) is a professional medical organization of more than 6,500 allergists-immunologists and allied health professionals, headquartered in Arlington Heights, Ill. Founded in 1942, the College fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy, and research. ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer immunotherapy, and provide patients with the best treatment outcomes. For more information and to find relief, visit AllergyandAsthmaRelief.org. Join us on Facebook, Instagram, Threads and X.
EARLY DUPILUMAB TREATMENT FOR PEDIATRIC EOSINOPHILIC ESOPHAGITIS IS ASSOCIATED WITH REDUCED INCIDENT ASTHMA
R052
K. Steinberger, Morgantown, WV.
Introduction: Eosinophilic esophagitis (EoE) and asthma are manifestations of the atopic march and share interleukin 4/interleukin 13-mediated type 2 inflammation. Whether early biologic treatment for pediatric EoE influences subsequent asthma development remains unknown. I compared the incidence of asthma among children with EoE treated with dupilumab versus oral budesonide.
Methods: A retrospective cohort study was performed using the TriNetX Research Network (January 2016 to January 2026). Children ≤6 years old diagnosed with EoE who received either dupilumab or oral budesonide were identified. Patients receiving dupilumab were excluded from the budesonide cohort. Propensity score matching was performed for baseline demographics and atopic dermatitis. Patients with asthma before the index event were excluded. Incident asthma occurring after the index event (first qualifying medication plus EoE diagnosis) was compared.
Results: After propensity score matching and exclusion of patients with pre-existing asthma, 401 budesonide-treated and 344 dupilumab-treated patients were analyzed. Incident asthma occurred in 16.2% of the budesonide cohort compared with 10.5% of the dupilumab cohort (risk difference 5.7%, P=0.022; risk ratio 1.55, 95% CI 1.06 to 2.27). The mean number of asthma diagnoses during follow up was also higher among budesonide-treated patients (0.743 vs 0.369 events per patient, P=0.028).
Conclusion: In this multicenter propensity-matched observational study, dupilumab treatment for pediatric EoE was associated with a significantly lower incidence of subsequent asthma compared with oral budesonide. These findings suggest that early interruption of type 2 inflammation may alter progression of the atopic march in susceptible children. Prospective studies are needed to determine whether dupilumab modifies future asthma risk.
