Eosinophilic Esophagitis Treatment: Tezspire Shows Promise

Eosinophilic esophagitis treatment could gain a potential new option after AstraZeneca and Amgen reported positive Phase III results for Tezspire (tezepelumab) in adolescents and adults.

Eosinophilic esophagitis (EoE), a chronic inflammatory disease affects the esophagus.

The CROSSING trial found that up to 68.9 percent of patients receiving the drug achieved histologic remission at 24 weeks, compared with 3.5 percent receiving placebo.

Improvements in swallowing difficulties were also reported, with benefits sustained through 52 weeks.

The findings, presented at United European Gastroenterology Week 2026, offer evidence that targeting an upstream inflammatory pathway could help patients whose disease remains uncontrolled.

However, Tezspire is not yet approved for EoE, and the findings do not establish when a new indication might become available.

How Does Tezspire Target Eosinophilic Esophagitis?

EoE occurs when eosinophils, a type of white blood cell associated with inflammatory responses, accumulate in the esophagus, causing difficulty in swallowing and narrowing of esophageal passage.

Existing eosinophilic esophagitis treatment options include proton pump inhibitors, swallowed topical corticosteroids and dietary management. However, some patients continue to experience the symptoms even after treatment.

Tezspire works by blocking thymic stromal lymphopoietin (TSLP), an epithelial cytokine involved in initiating multiple inflammatory pathways.

The trial tested 210 mg and 420 mg doses given every 4 weeks. The participants were allowed to stay on stable background treatments during the study, allowing researchers to assess the drug’s effect alongside the standard treatments for EoE.

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What Did the Trial Show at 24 and 52 Weeks?

The Phase III results demonstrated improvements across tissue inflammation, swallowing symptoms and visible signs of disease.

Key findings included:

• 64.8 percent of patients receiving 210 mg and 68.9 percent of patients receiving 420 mg achieved histologic remission at the end of 24 weeks, compared to 3.5 percent on placebo.
• 67.8 percent of patients receiving 210 mg and 63.3 percent of patients receiving 420 mg achieved histologic remission at the end of 52 weeks, compared to 5.4 percent on placebo.
• Dysphagia symptom questionnaire scores improved from baseline at both doses, with improvements sustained through week 52.
• No visible disease features were seen when observed through endoscopy in 34.4 percent of patients receiving 210 mg and 29.5 percent receiving 420 mg, compared with 4.1 percent on placebo.

Histologic remission, symptom improvement and endoscopic remission measure different aspects of the disease. Achieving one doesn’t mean all signs and symptoms of the disease have disappeared.

The most frequently reported adverse events included upper respiratory infections, headache and diarrhea.

What Could the Findings Mean for Future Eosinophilic Esophagitis Treatment?

The results could strengthen the case for evaluating TSLP inhibition in gastrointestinal inflammatory diseases.

Tezepelumab shows potential to be a key treatment option, with improvements observed across symptomatic, histologic and endoscopic outcomes.

Even so, these are only clinical trial results, and not an approval. Tezspire would need further regulatory clearance before it can be marketed as an eosinophilic esophagitis treatment option.

For AstraZeneca and Amgen, the findings expand the potential application of a medicine already approved for certain conditions, including severe asthma.

The findings therefore represent a promising development in EoE drug research, while leaving approval and the medicine's eventual place in clinical practice to be determined.