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Dupilumab Shows Consistent Efficacy in EoE Treatment Independent of Food Elimination Diets

• New research demonstrates that dupilumab effectively treats eosinophilic esophagitis (EoE) with comparable outcomes whether patients follow food elimination diets or not, addressing a key knowledge gap in treatment approaches.

• Clinical trial data reveals over 60% of patients on dupilumab achieved disease remission with 6 or fewer eosinophils per high power field, significantly outperforming placebo regardless of dietary restrictions.

• Long-term follow-up through 52 weeks showed sustained improvements in histological, symptomatic, and endoscopic measurements across all patient groups, supporting dupilumab's consistent therapeutic benefits.

A groundbreaking study presented at the 2025 American Academy of Allergy, Asthma & Immunology/World Allergy Organization Joint Congress in San Diego has revealed that dupilumab effectively treats eosinophilic esophagitis (EoE) regardless of patients' adherence to food elimination diets.
Dr. Antonella Cianferoni, associate professor of pediatrics at the Perelman School of Medicine, University of Pennsylvania, led research addressing a critical knowledge gap in EoE treatment. "EoE is a chronic, progressive disease driven in part by type 2 inflammation that damages the esophagus and impairs its function," she explained.

Clinical Trial Outcomes

The study demonstrated remarkable efficacy in both dietary and non-dietary groups. Among patients following food elimination diets, 61.3% receiving weekly 300 mg doses of dupilumab achieved disease remission (≤6 eosinophils per high power field) compared to just 3.4% in the placebo group at 24 weeks. Similarly, 57.1% of patients not following elimination diets achieved remission on dupilumab versus 8% on placebo.

Comprehensive Symptom Improvement

Dysphagia Symptom Questionnaire scores showed significant improvements across all treatment groups:
  • Patients on elimination diets: -26.25 (dupilumab) vs -18.27 (placebo)
  • Patients without dietary restrictions: -21.43 (dupilumab) vs -10.39 (placebo)
The research team observed comparable improvements in Endoscopic Reference Scores and EoE Histologic Scoring System results, with statistically significant differences (P < .0001) between dupilumab and placebo groups regardless of dietary status.

Long-term Efficacy and Future Research

The benefits of dupilumab persisted through 52 weeks of treatment, maintaining consistent improvements in histological, symptomatic, and endoscopic measurements. Patients who switched from placebo to dupilumab at week 24 demonstrated similar positive outcomes.
"These findings indicate that patients using dupilumab do not have to adjust their diets," Dr. Cianferoni noted. This revelation offers new flexibility in treatment approaches, particularly significant given that food elimination diets, while effective, can be challenging to maintain long-term.
A phase 4 study is currently underway to further investigate dupilumab's long-term efficacy and its impact on esophageal remodeling in EoE, promising additional insights into this therapeutic approach.
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