In the realm of eosinophilic esophagitis (EoE), the absence of comprehensive studies and clear recommendations regarding optimal monitoring strategies for patients has created a critical gap in clinical practice. Recognizing this need, the objective was to establish practical guidelines for the routine monitoring of individuals with EoE, grounded in both clinical evidence and expert consensus.

These Expert Recommendations have been developed on the initiative of the EUREOS Board members and international experts Ulrike von Armin, Arjan Bredenoord and Luc Biedermann. Implementation of these international, transatlantic EUREOS-TIGERS Expert Recommendations has been lead by Ulrike von Armin.

A diverse and international panel of EoE specialists convened in a series of consensus meetings to address three pivotal questions: why, how, and when to monitor EoE patients. This multidisciplinary endeavor culminated in the formation of a steering committee and the establishment of three expert teams, each tasked with reviewing existing literature and crafting statements for their respective areas of focus. To gauge consensus, a Delphi survey was conducted, with a consensus threshold set at ≥75% agreement. Finally, a concluding conference brought together these insights, fostering productive discourse and allowing for statement refinement as needed.

The Delphi survey included the participation of 18 EoE experts, comprising 14 adult and pediatric gastroenterologists, along with 2 pathologists and 2 allergists, boasting an average of 21.7 years of clinical experience. These experts were primarily affiliated with academic or university-based institutions. The survey consisted of 11 statements, as well as a proposed algorithm for monitoring EoE patients.