Clinical Trial: Dupilumab Improves Eosinophilic Oesophagitis Outcomes Versus Placebo Regardless of Comorbidities or Treatment History in a Randomised Clinical Trial
In brief
Dupilumab improved esophageal inflammation, swallowing and endoscopy across patient subgroups
In a post hoc analysis of a randomized trial, dupilumab improved histologic remission, swallowing symptoms and endoscopic findings versus placebo at 24 weeks across subgroups defined by comorbidities, disease history and prior or concurrent treatments. Gains persisted through 52 weeks with continued treatment, but the abstract gives no subgroup effect sizes, so the degree of benefit for individual patients remains unclear.
- Journal
- Alimentary pharmacology & therapeutics (Q1)
- Published
- 6 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Evan S Dellon, Marc E Rothenberg, Jonathan M Spergel, Albert J Bredenoord, Antonella Cianferoni, Changming Xia, et al.
- PMID
- 42836357
- DOI
- 10.1111/apt.71001
Why clinicians should know about it
- Picked for Immunology and Allergy (top studies of the week, 18 October 2026): Dupilumab RCT improves EoE outcomes
Abstract
BACKGROUND: Patients with eosinophilic oesophagitis (EoE) can present with differing disease characteristics, treatment resistance, and associated type 2 inflammatory comorbidities. We assessed the efficacy of dupilumab in subgroups of patients with EoE from the LIBERTY EoE TREET study across a range of demographics, characteristics, treatments, and comorbidities. METHODS: Patients were categorised by subgroups based on weight (< 60 kg or ≥ 60 kg), body mass index (< 18.5 kg/m2, ≥ 18.5 to < 30 kg/m2, ≥ 30 kg/m2), disease duration before study entry (< 5 years, ≥ 5 to < 10 years, ≥ 10 years), history of type 2 inflammatory comorbidities (with/without asthma, allergic rhinitis, atopic dermatitis, or food allergy), history of elimination diet, concurrent elimination diet, concurrent proton pump inhibitor use, and prior oesophageal dilation. Outcomes were analysed post hoc and included the proportion of patients achieving ≤ 6 eosinophils per high-power field (eos/hpf) and change from baseline in Dysphagia Symptom Questionnaire (DSQ) and total Endoscopic Reference Score (EREFS). RESULTS: At Week 24, dupilumab treatment increased the proportion of patients achieving histological remission (peak eosinophil count ≤ 6 eos/hpf) versus placebo in all subgroups. At Week 52, improvements were maintained with continued dupilumab treatment. Improvements were also observed through Week 52 in patients who switched from placebo to dupilumab at Week 24. Similar results were observed for change from baseline in DSQ and EREFS. CONCLUSIONS: Dupilumab treatment improved histological, symptomatic, and endoscopic outcomes versus placebo in patients with EoE, regardless of demographics, disease characteristics, treatment history, or type 2 inflammatory disease comorbidities. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03633617.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.