A Study Assessing Esophageal Function and Remodeling With Dupilumab Compared With Placebo for 24 Weeks Followed by 104 Weeks Open Label in Adult Participants With EoE (REMOdeling With Dupilumab in Eosinophilic Esophagitis Long-term Trial)

A Phase 4, Randomized, Multicenter, Double-blind, Parallel-group, 24 Weeks, Placebo-controlled Study Followed by 104 Weeks Open-label to Assess Dupilumab Efficacy on Esophageal Function and Remodeling in Adult Participants With Eosinophilic Esophagitis (EoE)

This is parallel, Phase 4 study which consists of a 24 week (0.5 years) randomized, double blind, placebo controlled, 2-arm treatment period followed by an open label segment of 104 weeks (2 years) for a total of 128 weeks (2.5 years) to evaluate the effect of dupilumab treatment on esophageal function, and remodeling in adults with eosinophilic esophagitis.

Duration of study period (per participant)

• Screening period: Up to 12 weeks before Week 0
• Randomized double-blind period: 24 weeks
• Open label period: 104 weeks
• Post Investigational Medicinal Product (IMP) intervention follow-up period: up to 12 weeks or until the participants switch to commercialized dupilumab, whatever comes first.

There will be ten (10) site visits, and five (5) direct-to-participant IMP delivery visits (except if prohibited by local regulatory authorities or if participant is not willing. In this case, IMP will be dispensed at the study site).

Study Overview

• Status: Active, not recruiting
• Conditions: Eosinophilic Oesophagitis
• Intervention / Treatment: Drug: Dupilumab; Drug: Placebo

Detailed Description

The duration per participant will be up to 152 weeks.

• Study Type: Interventional
• Enrollment (Actual): 69
• Phase: Phase 4

Contacts and Locations

Study Locations

• Brazil
  • São Paulo, Brazil, 01323-020
    • Hospital Alemao Oswaldo Cruz - São Paulo- Site Number : 0760003
  • Estado de Bahia
    • Salvador, Estado de Bahia, Brazil, 41825-010
      • Itaigara Memorial - Hospital Dia- Site Number : 0760005
  • Rio Grande do Sul
    • Porto Alegre, Rio Grande do Sul, Brazil, 90610-000
      • Hospital São Lucas da PUCRS - Porto Alegre - Avenida Ipiranga- Site Number : 0760006
  • São Paulo
    • Campinas, São Paulo, Brazil, 13010-001
      • Clínica Loema - Unidade I- Site Number : 0760007
    • Sorocaba, São Paulo, Brazil, 18040-425
      • Clinica de Alergia Martti Antila- Site Number : 0760001
• Canada
  • British Columbia
    • Vancouver, British Columbia, Canada, V5Z 1M9
      • Investigational Site Number : 1240006
    • Vancouver, British Columbia, Canada, V6Z 2K5
      • Investigational Site Number : 1240004
  • Quebec
    • Montreal, Quebec, Canada, H4A 3T2
      • Investigational Site Number : 1240002
• Israel
  • Haifa, Israel, 3104802
    • Investigational Site Number : 3760006
  • Haifa, Israel, 3109601
    • Investigational Site Number : 3760002
  • Jerusalem, Israel, 9103102
    • Investigational Site Number : 3760005
  • Jerusalem, Israel, 9112001
    • Investigational Site Number : 3760004
  • Tel Aviv, Israel, 6423906
    • Investigational Site Number : 3760003
• Switzerland
  • Wetzikon, Switzerland, 8620
    • Investigational Site Number : 7560001
  • Zurich, Switzerland, 8091
    • Investigational Site Number : 7560002
• United States
  • California
    • Murrieta, California, United States, 92563
      • United Gastroenterologists - Murrieta- Site Number : 8400001
    • San Francisco, California, United States, 94143
      • University of California San Francisco - Parnassus Heights- Site Number : 8400020
  • Florida
    • Jacksonville, Florida, United States, 32256
      • Borland Groover Clinic- Site Number : 8400016
  • Idaho
    • Boise, Idaho, United States, 83706
      • Treasure Valley Medical Research- Site Number : 8400018
  • Illinois
    • Chicago, Illinois, United States, 60611
      • Northwestern University- Site Number : 8400003
    • Glenview, Illinois, United States, 60026
      • GI Alliance - Glenview- Site Number : 8400012
    • Gurnee, Illinois, United States, 60031
      • Illinois Gastroenterology Group- Site Number : 8400004
  • Iowa
    • Iowa City, Iowa, United States, 52242
      • University of Iowa- Site Number : 8400006
  • Massachusetts
    • Worcester, Massachusetts, United States, 01655
      • University of Massachusetts Chan Medical School- Site Number : 8400019
  • Minnesota
    • Rochester, Minnesota, United States, 55905
      • Mayo Clinic Hospital Rochester- Site Number : 8400008
  • North Carolina
    • Chapel Hill, North Carolina, United States, 27514
      • University of North Carolina at Chapel Hill- Site Number : 8400007
  • Ohio
    • Cleveland, Ohio, United States, 44195
      • Cleveland Clinic - Cleveland- Site Number : 8400009
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19104
      • Penn Medicine: University of Pennsylvania Health System- Site Number : 8400010
  • Texas
    • Houston, Texas, United States, 77087
      • Private Practice - Dr. Martin Yudovich- Site Number : 8400015
    • Mansfield, Texas, United States, 76063
      • GI Alliance - Mansfield- Site Number : 8400017

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

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 participant report) of an average of at least 2 episodes of dysphagia (with intake of solids) per week in the 4 weeks prior to screening.
• Body weight ≥40 kg.

Exclusion Criteria:

Participants are excluded from the study if any of the following criteria apply:

• Other causes of esophageal eosinophilia or the following conditions: hypereosinophilic syndrome or 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.
• Treatment with swallowed topical corticosteroids within 8 weeks prior to baseline.
• Initiation or change of a food elimination diet regimen or reintroduction of a previously eliminated food group in the 6 weeks prior to screening.
• Participation in prior dupilumab clinical study or participants currently treated or have been treated with commercially available dupilumab or contraindicated to dupilumab per local labelling.

The above information is not intended to contain all considerations relevant to a potential participation in a clinical trial

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Dupilumab; Subcutaneous injection (SC) as per protocol	Drug: Dupilumab; Subcutaneous injection (SC) as per protocol
Placebo Comparator: Placebo; SC injection as per protocol	Drug: Placebo; SC injection as per protocol

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in esophageal distensibility plateau as measured by Functional Lumen Imaging Probe (EndoFLIP)	Distensibility plateau provides an assessment of esophageal function. An increase in distensibility plateau indicates an improvement in esophageal function and a decrease in distensibility plateau indicates a worsening of esophageal function.	From baseline to Week 24

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percent change from baseline in esophageal distensibility plateau as measured by Functional Lumen Imaging Probe	Distensibility plateau provides an assessment of esophageal function. An increase in distensibility plateau indicates an improvement in esophageal function and a decrease in distensibility plateau indicates a worsening of esophageal function.	From baseline up to Week 24
Absolute change from baseline in esophageal distensibility plateau as measured by Functional Lumen Imaging Probe	Distensibility plateau provides an assessment of esophageal function. An increase in distensibility plateau indicates an improvement in esophageal function and a decrease in distensibility plateau indicates a worsening of esophageal function.	From baseline up to Week128
Percent change from baseline in esophageal distensibility plateau as measured by Functional Lumen Imaging Probe	Distensibility plateau provides an assessment of esophageal function. An increase in distensibility plateau indicates an improvement in esophageal function and a decrease in distensibility plateau indicates a worsening of esophageal function.	From Baseline up to Week 128
Change from baseline in eosinophilic esophagitis-endoscopic reference score (EoE-EREFS)	EoE-EREFS, a scoring system for inflammatory and remodeling features of disease. The overall total score ranges from 0 to 18 with higher number indicating worse disease.	From baseline up to Week 128
Change from baseline in eosinophilic esophagitis (EoE-HSS) Grade	Severity (grade) and extent (stage) of esophageal abnormalities are scored using a 4-point scale (0 normal; 3 maximum change). Higher score indicates greater severity and extent of histological abnormalities.	From Baseline up to Week 128
Change from baseline in EoE-HSS Stage	Severity (grade) and extent (stage) of esophageal abnormalities are scored using a 4-point scale (0 normal; 3 maximum change). Higher score indicates greater severity and extent of histological abnormalities.	From Baseline up to Week 128
Proportion of participants who achieved peak Esophageal Intraepithelial Eosinophil Count of ≤6 eosinophils/high power field (Eos/HPF)	Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal).	At Weeks 24, 76 and 128
Proportion of participants who achieved peak Esophageal Intraepithelial Eosinophil Count of ≤15 Eos/HPF	Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal).	At Weeks 24, 76 and 128
Change from baseline in normalized enrichment score (NES) for EoE diagnostic panel (EDP) transcriptome signature	NES reflects the degree to which the activity level of a set of disease transcripts is overrepresented at the extremes (top or bottom) of the entire ranked list of transcripts within a sample and is normalized by accounting for the number of transcripts in the set. An NES of 0 indicates no change from baseline, a negative score reflects a reduction in the disease score (more like normal) and a positive score reflects worsening (more active disease).	From baseline up to Week 128 (EOT)
Change from baseline in normalized enrichment score (NES) for type 2 inflammation transcriptome signature	NES reflects the degree to which the activity level of a set of disease transcripts is overrepresented at the extremes (top or bottom) of the entire ranked list of transcripts within a sample and is normalized by accounting for the number of transcripts in the set. An NES of 0 indicates no change from baseline, a negative score reflects a reduction in the disease score (more like normal) and a positive score reflects worsening (more active disease).	From Baseline up to Week 128 (EOT)
Incidence of treatment-emergent adverse events (TEAEs), and serious adverse events (SAEs)		From the first IMP administration up to end of post treatment follow up period (week139)
Incidence of adverse events of special interest (AESIs)		From the first IMP administration up to end of post treatment follow up period (week139)

Collaborators and Investigators

• Sponsor: Sanofi
• Collaborators: Regeneron Pharmaceuticals
• Investigators: Study Director: Clinical Sciences & Operations, Sanofi

Publications and helpful links

General Publications

• Dellon ES, Savarino EV, Zaghloul S, Angello JT, Zhang M, Raphael BP, Radwan A, Bredenoord AJ. Study design of the phase IV, randomized, placebo-controlled REMOdeling with Dupilumab in Eosinophilic esophagitis Long-term (REMODEL) trial. Therap Adv Gastroenterol. 2025 Oct 9;18:17562848251383782. doi: 10.1177/17562848251383782. eCollection 2025.

Helpful Links

• LPS17558 Plain Language Results Summary

Study record dates

Study Major Dates

• Study Start (Actual): November 29, 2023
• Primary Completion (Actual): November 5, 2025
• Study Completion (Estimated): February 1, 2028

Study Registration Dates

• First Submitted: October 19, 2023
• First Submitted That Met QC Criteria: October 19, 2023
• First Posted (Actual): October 25, 2023

Study Record Updates

• Last Update Posted (Actual): December 23, 2025
• Last Update Submitted That Met QC Criteria: December 22, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Immune System Diseases; Digestive System Diseases; Gastrointestinal Diseases; Hypersensitivity, Immediate; Hypersensitivity; Eosinophilia; Leukocyte Disorders; Hematologic Diseases; Esophageal Diseases; Gastroenteritis; Esophagitis; Hemic and Lymphatic Diseases; Eosinophilic Esophagitis; dupilumab
• Other Study ID Numbers: LPS17558; U1111-1280-5266 (Registry Identifier: ICTRP); 2022-502491-23 (Registry Identifier: CTIS)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No