Study to Determine the Efficacy and Safety of Dupilumab in Adult and Adolescent Patients With Eosinophilic Esophagitis (EoE)

NCT ID: NCT03633617

Last Updated: 2023-06-28

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

321 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-24

Study Completion Date

2022-06-07

Brief Summary

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The primary objectives of the study by study part are:

Part A:

To determine the treatment effect of dupilumab compared with placebo in adult and adolescent patients with EoE after 24 weeks of treatment as assessed by histological and clinical measures and to inform/confirm the final sample size determination for Part B.

Part B:

To demonstrate the efficacy of dupilumab treatment compared with placebo in adult and adolescent patients with EoE after 24 weeks of treatment as assessed by histological and clinical measures.

Part C:

To assess the safety and efficacy of dupilumab treatment in adult and adolescent patients with EoE after up to 52 weeks of treatment as assessed by histological and clinical measures.

The secondary objectives of the study are:

* To evaluate the safety, tolerability, and immunogenicity of dupilumab treatment for up to 52 weeks in adult and adolescent patients with EoE
* To explore the relationship between dupilumab concentration and responses in adult and adolescent patients with EoE, using descriptive analyses
* To evaluate the effects of dupilumab on transcriptomic signatures associated with EoE and type 2 inflammation
* To demonstrate the efficacy of dupilumab treatment compared to placebo after 24 weeks and 52 weeks of treatment in adult and adolescent patients with EoE who have previously received swallowed topical corticosteroids

Detailed Description

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Conditions

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Eosinophilic Esophagitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Part A: Dupilumab or Placebo

Part A consists of a 24-week double-blind treatment period. Participants will be randomized to receive dupilumab or placebo. At the end of the double-blind treatment visit (week 24), eligible participants may enter Part C. Participants who do not enter Part C will enter a 12-week follow-up period.

Group Type EXPERIMENTAL

Dupilumab

Intervention Type DRUG

Solution for injection administered subcutaneously

Placebo

Intervention Type DRUG

Matching placebo

Part B: Dupilumab or Placebo

Part B consists of a 24-week double-blind treatment period. Participants will be randomized to receive dupilumab dosing regimen 1, dupilumab dosing regimen 2 or placebo. At the end of the double-blind treatment visit (week 24), eligible participants may enter Part C. Participants who do not enter Part C will enter a 12-week follow-up period.

Group Type EXPERIMENTAL

Dupilumab

Intervention Type DRUG

Solution for injection administered subcutaneously

Placebo

Intervention Type DRUG

Matching placebo

Part C: Dupilumab

Part C is a 28-week extended active treatment period. Participants will receive dupilumab dosing regimen 1, dupilumab dosing regimen 2. At the end of the treatment period (week 52), participants will enter a 12-week follow-up period.

Group Type EXPERIMENTAL

Dupilumab

Intervention Type DRUG

Solution for injection administered subcutaneously

Interventions

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Dupilumab

Solution for injection administered subcutaneously

Intervention Type DRUG

Placebo

Matching placebo

Intervention Type DRUG

Other Intervention Names

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DUPIXENT REGN668 SAR231893

Eligibility Criteria

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Inclusion Criteria

* A documented diagnosis of EoE by endoscopic biopsy
* Baseline endoscopic biopsies with a demonstration on central reading of intraepithelial eosinophilic infiltration
* History (by patient report) of an average of at least 2 episodes of dysphagia (with intake of solids) per week in the 4 weeks prior to screening

Exclusion Criteria

* Body weight ≤40 kg
* Prior participation in a dupilumab clinical trial, or past or current treatment with dupilumab
* Initiation or change of a food-elimination diet regimen or re-introduction of a previously eliminated food group in the 6 weeks prior to screening.
* Other causes of esophageal eosinophilia or the following conditions: hypereosinophilic syndrome and eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)
* Active Helicobacter pylori infection
* History of achalasia, Crohn's disease, ulcerative colitis, celiac disease, and prior esophageal surgery
* Any esophageal stricture unable to be passed with a standard, diagnostic, 9 to10 mm upper endoscope or any critical esophageal stricture that requires dilation at screening
* History of bleeding disorders or esophageal varices
* Pregnant or breastfeeding women, or women planning to become pregnant or breastfeed during the study


* Participants who, during Part A or Part B, developed a serious adverse event (SAE) and/or adverse event (AE) deemed related to study drug, which in the opinion of the investigator could indicate that continued treatment with study drug may present an unreasonable risk for the participant
* Participants who became pregnant during Part A or Part B
* Participants who are prematurely discontinued from study drug due to an AE (patients who are prematurely discontinued from study drug due to lack of efficacy are eligible to enter Part C)
* Patients who did not undergo endoscopy with biopsies prior to receiving rescue treatment
Minimum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sanofi

INDUSTRY

Sponsor Role collaborator

Regeneron Pharmaceuticals

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clinical Trial Management

Role: STUDY_DIRECTOR

Regeneron Pharmaceuticals

Locations

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Phoenix, Arizona, United States

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Scottsdale, Arizona, United States

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Little Rock, Arkansas, United States

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La Jolla, California, United States

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Los Angeles, California, United States

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Mountain View, California, United States

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Orange, California, United States

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Rolling Hills Estates, California, United States

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San Diego, California, United States

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Aurora, Colorado, United States

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Aurora, Colorado, United States

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Colorado Springs, Colorado, United States

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Lone Tree, Colorado, United States

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Bristol, Connecticut, United States

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Miami, Florida, United States

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St. Petersburg, Florida, United States

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Boise, Idaho, United States

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Idaho Falls, Idaho, United States

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Chicago, Illinois, United States

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Chicago, Illinois, United States

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Park Ridge, Illinois, United States

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Urbana, Illinois, United States

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Indianapolis, Indiana, United States

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Clive, Iowa, United States

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Iowa City, Iowa, United States

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Topeka, Kansas, United States

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Hagerstown, Maryland, United States

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Boston, Massachusetts, United States

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Worcester, Massachusetts, United States

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Ann Arbor, Michigan, United States

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Chesterfield, Michigan, United States

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Plymouth, Minnesota, United States

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Rochester, Minnesota, United States

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Lincoln, Nebraska, United States

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Omaha, Nebraska, United States

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Great Neck, New York, United States

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Great Neck, New York, United States

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New York, New York, United States

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New York, New York, United States

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New York, New York, United States

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The Bronx, New York, United States

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Chapel Hill, North Carolina, United States

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Cincinnati, Ohio, United States

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Dayton, Ohio, United States

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Dublin, Ohio, United States

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Mentor, Ohio, United States

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Hershey, Pennsylvania, United States

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Philadelphia, Pennsylvania, United States

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Charleston, South Carolina, United States

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Greenville, South Carolina, United States

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Johnson City, Tennessee, United States

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Memphis, Tennessee, United States

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Dallas, Texas, United States

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Fort Worth, Texas, United States

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Garland, Texas, United States

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Houston, Texas, United States

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San Antonio, Texas, United States

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Salt Lake City, Utah, United States

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Charlottesville, Virginia, United States

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Roanoke, Virginia, United States

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Seattle, Washington, United States

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Milwaukee, Wisconsin, United States

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Camperdown, New South Wales, Australia

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Woolloongabba, Queensland, Australia

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Elizabeth Vale, South Australia, Australia

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Melbourne, Victoria, Australia

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Bruges, , Belgium

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Edegem, , Belgium

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Leuven, , Belgium

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London, Ontario, Canada

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Ottawa, Ontario, Canada

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Montreal, Quebec, Canada

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Hamilton, , Canada

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Pessac, , France

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Toulouse, , France

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Hanover, , Germany

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Magdeburg, , Germany

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Munich, , Germany

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Genoa, , Italy

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Milan, , Italy

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Naples, , Italy

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Pisa, , Italy

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Rome, , Italy

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Rome, , Italy

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Rozzano, , Italy

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Amsterdam, , Netherlands

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Maastricht, , Netherlands

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Nijmegen, , Netherlands

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Tomelloso, Ciudad Real, Spain

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Barcelona, , Spain

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Madrid, , Spain

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Stockholm, , Sweden

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Zurich, , Switzerland

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London, Whitechapel, United Kingdom

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Barnsley, Yorkshire, United Kingdom

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Countries

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United States Australia Belgium Canada France Germany Italy Netherlands Spain Sweden Switzerland United Kingdom

References

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Bredenoord AJ, Dellon ES, Schlag C, Cianferoni A, Xia C, Pela T, Durrani S, Radwan A, Jacob-Nara JA. Dupilumab is efficacious for eosinophilic esophagitis irrespective of prior swallowed budesonide or fluticasone, or prior treatments used alongside swallowed topical corticosteroids: results from the phase 3, randomized, placebo-controlled, LIBERTY EoE TREET trial. Expert Rev Gastroenterol Hepatol. 2025 Jan-Feb;19(2):197-209. doi: 10.1080/17474124.2025.2461516. Epub 2025 Feb 5.

Reference Type DERIVED
PMID: 39909733 (View on PubMed)

Spergel JM, Chehade M, Dellon ES, Bredenoord AJ, Sun X, Glotfelty L, Shabbir A, Tilton ST, McCann E. Dupilumab Improves Health-Related Quality of Life and a Range of Symptoms in Patients With Eosinophilic Esophagitis. Am J Gastroenterol. 2024 Dec 1;119(12):2398-2407. doi: 10.14309/ajg.0000000000002924. Epub 2024 Jun 28.

Reference Type DERIVED
PMID: 38940435 (View on PubMed)

Bredenoord AJ, Dellon ES, Hirano I, Lucendo AJ, Schlag C, Sun X, Glotfelty L, Mannent L, Maloney J, Laws E, Mortensen E, Shabbir A. Dupilumab demonstrated efficacy and was well tolerated regardless of prior use of swallowed topical corticosteroids in adolescent and adult patients with eosinophilic oesophagitis: a subgroup analysis of the phase 3 LIBERTY EoE TREET study. Gut. 2024 Feb 23;73(3):398-406. doi: 10.1136/gutjnl-2023-330220.

Reference Type DERIVED
PMID: 38050037 (View on PubMed)

McCann E, Chehade M, Spergel JM, Yaworsky A, Symonds T, Stokes J, Tilton ST, Sun X, Kamat S. Validation of the novel Eosinophilic Esophagitis Impact Questionnaire. J Patient Rep Outcomes. 2023 Nov 27;7(1):120. doi: 10.1186/s41687-023-00654-z.

Reference Type DERIVED
PMID: 38010430 (View on PubMed)

Rothenberg ME, Dellon ES, Collins MH, Hirano I, Chehade M, Bredenoord AJ, Lucendo AJ, Spergel JM, Sun X, Hamilton JD, Mortensen E, Laws E, Maloney J, Mannent LP, McCann E, Liu X, Glotfelty L, Shabbir A. Efficacy and safety of dupilumab up to 52 weeks in adults and adolescents with eosinophilic oesophagitis (LIBERTY EoE TREET study): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Gastroenterol Hepatol. 2023 Nov;8(11):990-1004. doi: 10.1016/S2468-1253(23)00204-2. Epub 2023 Aug 31.

Reference Type DERIVED
PMID: 37660704 (View on PubMed)

Dellon ES, Rothenberg ME, Collins MH, Hirano I, Chehade M, Bredenoord AJ, Lucendo AJ, Spergel JM, Aceves S, Sun X, Kosloski MP, Kamal MA, Hamilton JD, Beazley B, McCann E, Patel K, Mannent LP, Laws E, Akinlade B, Amin N, Lim WK, Wipperman MF, Ruddy M, Patel N, Weinreich DR, Yancopoulos GD, Shumel B, Maloney J, Giannelou A, Shabbir A. Dupilumab in Adults and Adolescents with Eosinophilic Esophagitis. N Engl J Med. 2022 Dec 22;387(25):2317-2330. doi: 10.1056/NEJMoa2205982.

Reference Type DERIVED
PMID: 36546624 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan: Part A/Part C

View Document

Document Type: Statistical Analysis Plan: Part B/Part C

View Document

Other Identifiers

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2018-000844-25

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

R668-EE-1774

Identifier Type: -

Identifier Source: org_study_id

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