N Nguyen , M Bauer. JPGN Rep. 2026;1-3.  Successful treatment of eosinophilic esophagitis with upadacitinib prescribed for atopic dermatitis. doi:10.1002/jpr3.70170

This case report describes a 15 yo with severe atopic dermatitis and multiple atopic diseases whose eosinophilic esophagitis remained in remission after starting upadacitinib, a JAK1 inhibitor, and stopping dupilumab. JAK1 inhibitors, such as upadacitinib and abrocitinib, are approved for severe AD. 

The discussion notes that there had been a prior case report of tofacitinib, a JAK1/JAK3 inhibitor, effectively treating refractory EoE. The authors “hypothesize that JAK inhibition of key Th1 and Th2 signaling pathways including IL-4, IL-13, and TSLP could effectively treat EoE, while also treating AD.”

My take (borrowed from authors): “If upadacitinib is used for the treatment of AD, cessation of other therapies for EoE, particularly biologics like dupilumab, should be strongly considered.”

Related blog posts:

• Upadacitinib for Pediatric Ulcerative Colitis
• Upadacitinib for Crohn’s Disease: U-ENDURE Study
• “Real-World” Experience: High Dose Upadacitinib Recaptures IBD Response
• Long-term Efficacy and Safety of Upadacitinib for Ulcerative Colitis
• Upadacitinib’s Effectiveness for Perianal Fistulizing Crohn’s Disease
• Drug Therapy for Celiac Disease: Case Report (Tofacitinib) Another beneficial off-target effect
• Dupilumab (Dupixent) for Young Children with Eosinophilic Esophagitis (Published Data)
• “Real-World” Dupilumab for Eosinophilic Esophagitis
• When to Use Dupilumab for Eosinophilic Esophagitis: Multispecialty Guidelines
• Dupixent Approved in Younger Children (15 kg+) (Dupixent dosing)
• Dupilumab for FPIES