May 2025 Research Roundup: DDW Edition

Digestive Disease Week (DDW) 2025, held in San Diego, showcased significant advancements in the understanding and treatment of eosinophilic gastrointestinal diseases (EGIDs), with many sessions focused on eosinophilic esophagitis (EoE).

The conference highlighted the growing recognition of mast cells’ role in EoE pathogenesis (how a disease starts and develops), suggesting new therapeutic targets beyond eosinophils. There was also an emphasis on patient-centered care, including less invasive diagnostic methods and personalized treatment plans, to improve quality of life for those with EGIDs.

Session Highlights

Ikuo Hirano Eosinophilic Gastrointestinal Diseases Symposium. A special session named in honor of the late Dr. Ikuo Hirano was held on May 3. Despite progress in understanding and treating EoE, some aspects of care remain debated, like whether allergy testing should be done routinely, how often endoscopies are needed to monitor the disease, and what treatments should be started first. This session aimed to review the latest research and explore different approaches to these important clinical decisions.

Eosinophilic Esophagitis: Swallowing Made Simple. A session titled “Eosinophilic Esophagitis: Swallowing Made Simple” focused on practical approaches doctors can take to manage EoE. It covered topics such as diet changes, medications, and medical procedures to help make swallowing easier and improve health for people with EoE.

Research Highlights

Barzolvolimab Shows Promise in EoE Treatment. Histology data from the Phase 2 “EvolvE” study of barzolvolimab in treating EoE was presented. Barzolvolimab is biologic that depletes mast cells. Biopsies showed that people with EoE had a lot of mast cells in their tissue, and these numbers matched up with how many eosinophils they had. The findings support the potential therapeutic benefit of barzolvolimab in EoE.

Dupilumab Shows Promising, Sustained Benefits for Eosinophilic Gastritis. Results of CEGIR’s DEGAS study were presented at DDW 2025, showing that dupilumab, a biologic therapy, significantly improved gastric eosinophil counts as well as histopathologic, endoscopic, and transcriptomic outcomes in adults and adolescents with eosinophilic gastritis (EoG) compared to placebo. These improvements were seen by Week 12 and sustained or enhanced through Week 36, supporting dupilumab’s potential as an effective treatment for EoG and suggesting its benefits may extend beyond EoE to other eosinophilic gastrointestinal diseases.

Abstract Awards

APFED & AAFA Poster Receives Award. Two poster abstracts related to the Life with EoE report were accepted for presentation at DDW.

• Barriers To Gastroenterology Referrals In Eosinophilic Esophagitis (EoE)
• Patient Perspectives On Diagnostic Challenges In Eosinophilic Esophagitis (EoE)

The first poster was awarded as a “Poster of Distinction.” An average of 4,500 abstracts are submitted to DDW each year, and only 10% are recognized with this award.

2025 AGA-APFED Abstract Award in Eosinophilic GI Diseases

The AGA-APFED Abstract Award in Eosinophilic Gastrointestinal Diseases is a collaborative initiative between the American Gastroenterological Association (AGA) and APFED. This award recognizes outstanding research abstracts in the field of EGIDs presented at DDW. Recipients receive a small monetary award to offset travel expenses, enabling them to share their findings with the medical community. These awards are made possible by APFED donors. Congratulations to the 2025 recipients:

Maya Kota, Northwestern University Feinberg School of Medicine, Chicago, IL

Abstract Title: Validation Of The Eosinophilic Esophagitis Endoscopic Reference Score As A Predictor Of Disease Outcomes: Thinking Beyond Eosinophils

This study looked at how helpful a tool called the EREFS score is for predicting problems in people with EoE. The EREFS score is a system doctors use during an endoscopy to look at and grade how the esophagus appears inside.

The researchers reviewed medical records from 350 adults with EoE who had endoscopies. They wanted to see if the EREFS score could predict serious problems—like food getting stuck, needing the esophagus stretched (dilation), or going to the ER because of EoE—within one year.

They found that:

• Higher total EREFS scores were linked to more problems.
• The fibrostenotic sub-score (which looks at narrowing and stiffness) and the presence of strictures (tight areas) were especially good at predicting issues.
• The inflammatory sub-score had only a small link to complications.

This study shows that the EREFS score could be a useful way to tell which patients are more likely to have trouble and may help doctors better track how EoE treatments are working in future research.

Angelica Rae Lackey, University of North Carolina

Abstract Title: Increasing social vulnerability impacts EoE presentation and decreases treatment response in eosinophilic esophagitis

This study looked at whether a person’s social vulnerability—a measure based on things like income, education, housing, and access to transportation—impacts their experience with EoE. Researchers used data from over 1,400 patients newly diagnosed with EoE at UNC and linked their zip codes to the Social Vulnerability Index (SVI), a scale from 0 to 1 (with 1 meaning the highest vulnerability).

This study found that:

• People with higher social vulnerability often had delays in getting diagnosed.
• They were more likely to show symptoms like vomiting, nausea, and stomach pain.
• For those treated with swallowed steroid medicine (called topical corticosteroids), people with higher vulnerability were less likely to show improvement when their esophagus was rechecked.
• This difference stayed even after considering other factors like age, race, and type of insurance.
• However, this pattern wasn’t seen in people who used diet changes as treatment.

This study suggests that people who face more social or economic challenges may not respond as well to certain EoE treatments—possibly due to issues like stress, treatment access, or follow-through. More research is needed to understand why this happens and how to better support patients.

Tursun Turapov, University of Utah 

Abtract Title: Gastrointestinal Tract Mucosal Eosinophils In Healthy Adults

Researchers wanted to figure out what “normal” eosinophil levels look like in healthy adults. They asked 25 volunteers with no GI symptoms to undergo scopes of both their upper and lower digestive tracts. Biopsies were taken from many different areas, including the esophagus, stomach, small intestine, and colon.

Researchers found that:

• Eosinophil levels varied widely depending on the location.
  • Very few eosinophils were found in the esophagus and rectum.
  • The small intestine and parts of the colon had the highest numbers.
• Eosinophils were spread out evenly in the tissue and did not form clusters.

Understanding what is typical is key to developing better tests and treatment for EGIDs.

DDW in Photos