This ASG video tip is sponsored by Braintree, maker of the newly approved Soufflave and Soutab. And so overall, for my AOE therapeutic algorithm, I think about inflammatory therapy and fibrostimulantic therapy. So both of these should be done. Within inflammatory therapy, do they want medical or diet? And you really sit and you counsel the patient on all of the treatment options. Typically, we'll start with proton pump inhibitors if they're not in remission, considering escalation to topical steroids. And we also talked about specific situations where you may want to escalate to dupilumab. If they're still not in remission, we could consider the other therapy or consider transitioning over to dietary therapy. If patients have tried all of that and are still not in remission, that's when we refer to our clinical trials or I would consider combination therapy. So I rarely start with combination therapy. Usually you can get patients in remission on medical or dietary therapy. If patients for inflammatory therapy choose not to have medical therapy and want to go towards diet, we talked about that process. And if they're not in remission on that, we would consider medical therapy. And then for fibrostimulantic therapy, we'll do our careful control dilation. Our goal is 16. If the dilator size is greater than or equal to 16 and they're still having symptoms, I would consider a distensibility evaluation via endoflip, which can sometimes be helpful in these specific cases. And so briefly, I'll touch on maintenance therapy. There are many, many graphs that I could choose from to show you that look like this. So this on the Y-axis is the proportion of EOE patients in deep remission for months. And then at time zero, we stop their topical steroids. And you can see relapse quite quickly. In this study, 82% of patients with clinical relapse off therapy at a median of 5.5 months. So EOE is a chronic disease and relapse is common after treatment cessation. And so lifelong maintenance therapy is recommended and the patient should be counseled on that. So if you put a patient on therapy and you allow them to stop it and you will come to your house and punch a hole in your wall. Lastly, for long-term management, an international expert panel did note that unchecked inflammation may lead to fibrostatic complications and treatment may become ineffective over time, even when patients are taking it perfectly or patients may self-cease therapy. And so after deep remission is achieved, regular clinic follow-up at 12 to 24 month intervals is recommended, but also, you know, to check in on the new therapies, what's new for EOE. There's a lot of things emerging as we have discussed. And so our summary and key points today, the goals of EOE therapy are to improve symptoms, control inflammation, and prevent fibrostatic complications. Drug or diet therapy alone will achieve remission in most patients. And shared decision-making is really key given the diversity of our treatment options. Maintenance therapy and regular follow-up is recommended. And I think the future is bright with numerous potential novel therapies. Thank you.

Eosinophilic Esophagitis

Therapeutic options

Proton pump inhibitors

Dupilumab

Combination therapy