Long-term efficacy data of dupilumab for eosinophilic oesophagitis

Dupilumab showed maintained patient benefits for eosinophilic oesophagitis. The 28-week phase 3 trial showed sustained symptomatic, histologic, and endoscopic benefits.

Co-primary endpoint included absolute change in Dysphagia Symptom Questionnaire (DSQ) score

Dupilumab is a human monoclonal antibody inhibiting IL-4 and IL-13. Part A of the LIBERTY EoE TREET trial (NCT03633617) demonstrated that 300 mg dupilumab (subcutaneous injection, once weekly) was more efficacious than placebo after 24 weeks in a symptomatic, severely inflamed population of EoE patients. Part C of the trial investigated the long-term efficacy and safety of dupilumab in a 28-week extended treatment period1.

All patients (n=77) who completed part A were enrolled in part C and received 300 mg dupilumab (subcutaneous injection, once weekly). Co-primary endpoints were the absolute change in Dysphagia Symptom Questionnaire (DSQ) score and the proportion of patients achieving peak oesophageal intraepithelial eosinophil count of ≤6 eosinophils/high-power field at week 52. The findings were presented by Dr Evan Dellon (University of North Carolina, NC, USA).

Treatment-emergent adverse events were mostly mild, injection-site

After 52 weeks, the reductions in DSQ scores were maintained for patients who were randomised to the dupilumab condition in part A of the trial (LS mean: -21.9 at 24 weeks; -23.4 at 52 weeks). Patients who were originally randomised to placebo showed similar changes in DSQ score at 52 weeks (LS mean: -9.6 at 24 weeks; -21.7 at 52 weeks). The intraepithelial eosinophil counts showed a comparable pattern: the proportion of patients that achieved an eosinophil count of ≤6 eosinophils/high-power field in the dupilumab arm in part A of the trial was maintained throughout part C (percentage of responders: 59.5% at 24 weeks; 55.9% at 52 weeks).

Original placebo receivers showed similar response rates after 52 weeks (percentage of responders: 5.1% at 24 weeks; 60.0% at 52 weeks). Treatment-emergent adverse events (AEs) were mostly mild, injection-site reactions and injection-site erythema being the most common. Two treatment-emergent AEs led to discontinuation of the study.

Reference
  1. Dellon ES, et al. Dupilumab Efficacy and Safety up to 52 Weeks in Adult and Adolescent Patients With Eosinophilic Oesophagitis: Results From Part A and C of a Randomized, Placebo-Controlled, Three-Part, Phase 3 LIBERTY EoE TREET Study. LB10, UEG Week 2021, 3-5 October.