A new biologic could shake up treatment for a stubborn gut condition. The phase 3 CROSSING trial found that once-monthly subcutaneous tezepelumab — a monoclonal antibody that blocks thymic stromal lymphopoietin (TSLP) — delivered significant improvements in histologic remission, dysphagia symptoms, and endoscopic scores in adults and adolescents with eosinophilic esophagitis (EoE) compared to placebo. Results were presented at the ACG 2026 Annual Scientific Meeting.

EoE is a chronic inflammatory condition of the esophagus that causes chest pain and food impaction, and current standard therapies — including proton pump inhibitors and topical corticosteroids — leave many patients inadequately treated. Tezepelumab, already approved for asthma and chronic rhinosinusitis with nasal polyps, targets TSLP, an epithelial alarmin upstream of the Th2 inflammatory pathway that is elevated in esophageal tissue in EoE patients.

By the Numbers:

• Histologic remission at week 24: 64.8% (210 mg) and 68.9% (420 mg) vs 3.5% with placebo
• Remission sustained at week 52: 67.8% (210 mg) and 63.3% (420 mg) vs 5.4% placebo
• Both doses improved DSQ, EREFS, and HSS grade/stage scores vs placebo (P < .001 for most endpoints)
• Adverse events were comparable between tezepelumab and placebo groups

Why it matters: EoE remains a significant unmet need, and tezepelumab's once-monthly dosing, novel mechanism, and consistent improvements across symptom, histologic, and endoscopic outcomes could make it a valuable new option — especially for patients who don't respond to or can't sustain current therapies.