The standard of care for treatment of patients with eosinophilic esophagitis (EoE) is the use of swallowed topical corticosteroids in those who fail therapy with, or opt to avoid the use of, proton pump inhibitors (PPIs) or elimination diet. There are currently no US Food and Drug Administration–approved therapies for the treatment of EoE. Although several trials have assessed the efficacy of oral viscous budesonide or swallowed fluticasone via metered dose inhaler (MDI), until now no trials have compared the efficacy of these 2 medications head to head.