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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03633617
Other study ID # R668-EE-1774
Secondary ID 2018-000844-25
Status Completed
Phase Phase 3
First received
Last updated
Start date September 24, 2018
Est. completion date June 7, 2022

Study information

Verified date June 2023
Source Regeneron Pharmaceuticals
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

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


Recruitment information / eligibility

Status Completed
Enrollment 321
Est. completion date June 7, 2022
Est. primary completion date September 9, 2021
Accepts healthy volunteers No
Gender All
Age group 12 Years and older
Eligibility Key Inclusion Criteria (Parts A & B): - 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 Key Exclusion Criteria (Parts A & B): - 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 Key Exclusion Criteria (Part C): - 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 Note: Other inclusion/ exclusion criteria apply

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Dupilumab
Solution for injection administered subcutaneously
Placebo
Matching placebo

Locations

Country Name City State
Australia Regeneron Study Site Camperdown New South Wales
Australia Regeneron Study Site Elizabeth Vale South Australia
Australia Regeneron Study Site Melbourne Victoria
Australia Regeneron Study Site Woolloongabba Queensland
Belgium Regeneron Study Site Bruges
Belgium Regeneron Study Site Edegem
Belgium Regeneron Study Site Leuven
Canada Regeneron Study Site Hamilton
Canada Regeneron Study Site London Ontario
Canada Regeneron Study Site Montreal Quebec
Canada Regeneron Study Site Ottawa Ontario
France Regeneron Study Site Pessac
France Regeneron Study Site Toulouse
Germany Regeneron Study Site Hannover
Germany Regeneron Study Site Magdeburg
Germany Regeneron Study Site Munich
Italy Regeneron Study Site Genoa
Italy Regeneron Study Site Milano
Italy Regeneron Study Site Naples
Italy Regeneron Study Site Pisa
Italy Regeneron Study Site Rome
Italy Regeneron Study Site Rome
Italy Regeneron Study Site Rozzano
Netherlands Regeneron Study Site Amsterdam
Netherlands Regeneron Study Site Maastricht
Netherlands Regeneron Study Site Nijmegen
Spain Regeneron Study Site Barcelona
Spain Regeneron Study Site Madrid
Spain Regeneron Study Site Tomelloso Ciudad Real
Sweden Regeneron Study Site Stockholm
Switzerland Regeneron Study Site Zurich
United Kingdom Regeneron Study Site Barnsley Yorkshire
United Kingdom Regeneron Study Site London Whitechapel
United States Regeneron Study Site Ann Arbor Michigan
United States Regeneron Study Site Aurora Colorado
United States Regeneron Study Site Aurora Colorado
United States Regeneron Study Site Boise Idaho
United States Regeneron Study Site Boston Massachusetts
United States Regeneron Study Site Bristol Connecticut
United States Regeneron Study Site Bronx New York
United States Regeneron Study Site Chapel Hill North Carolina
United States Regeneron Study Site Charleston South Carolina
United States Regeneron Study Site Charlottesville Virginia
United States Regeneron Study Site Chesterfield Michigan
United States Regeneron Study Site #1 Chicago Illinois
United States Regeneron Study Site #2 Chicago Illinois
United States Regeneron Study Site Cincinnati Ohio
United States Regeneron Study Site Clive Iowa
United States Regeneron Study Site Colorado Springs Colorado
United States Regeneron Study Site Dallas Texas
United States Regeneron Study Site Dayton Ohio
United States Regeneron Study Site Dublin Ohio
United States Regeneron Study Site Fort Worth Texas
United States Regeneron Study Site Garland Texas
United States Regeneron Study Site Great Neck New York
United States Regeneron Study Site Great Neck New York
United States Regeneron Study Site Greenville South Carolina
United States Regeneron Study Site Hagerstown Maryland
United States Regeneron Study Site Hershey Pennsylvania
United States Regeneron Study Site Houston Texas
United States Regeneron Study Site Idaho Falls Idaho
United States Regeneron Study Site Indianapolis Indiana
United States Regeneron Study Site Iowa City Iowa
United States Regeneron Study Site Johnson City Tennessee
United States Regeneron Study Site La Jolla California
United States Regeneron Study Site Lincoln Nebraska
United States Regeneron Study Site Little Rock Arkansas
United States Regeneron Study Site Lone Tree Colorado
United States Regeneron Study Site Los Angeles California
United States Regeneron Study Site Memphis Tennessee
United States Regeneron Study Site Mentor Ohio
United States Regeneron Study Site Miami Florida
United States Regeneron Study Site Milwaukee Wisconsin
United States Regeneron Study Site Mountain View California
United States Regeneron Study Site New York New York
United States Regeneron Study Site New York New York
United States Regeneron Study Site New York New York
United States Regeneron Study Site Omaha Nebraska
United States Regeneron Study Site Orange California
United States Regeneron Study Site Park Ridge Illinois
United States Regeneron Study Site Philadelphia Pennsylvania
United States Regeneron Study Site Phoenix Arizona
United States Regeneron Study Site Plymouth Minnesota
United States Regeneron Study Site Roanoke Virginia
United States Regeneron Study Site Rochester Minnesota
United States Regeneron Study Site Rolling Hills Estates California
United States Regeneron Study Site Saint Petersburg Florida
United States Regeneron Study Site Salt Lake City Utah
United States Regeneron Study Site San Antonio Texas
United States Regeneron Study Site San Diego California
United States Regeneron Study Site Scottsdale Arizona
United States Regeneron Study Site Seattle Washington
United States Regeneron Study Site Topeka Kansas
United States Regeneron Study Site Urbana Illinois
United States Regeneron Study Site Worcester Massachusetts

Sponsors (2)

Lead Sponsor Collaborator
Regeneron Pharmaceuticals Sanofi

Countries where clinical trial is conducted

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

Outcome

Type Measure Description Time frame Safety issue
Primary Percentage of Participants Achieving Peak Esophageal Intraepithelial Eosinophil Count of =6 Eosinophils Per High-power Field (Eos/Hpf) in All Three Regions at Week 24 Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). At week 24
Primary Absolute Change From Baseline in Dysphagia Symptom Questionnaire (DSQ) Total Score at Week 24 The DSQ is used to measure the frequency and intensity of dysphagia. DSQ scores can range from 0 to 84, with a lower score indicating less-frequent or less-severe dysphagia. Baseline and week 24
Secondary Percent Change From Baseline in Peak Esophageal Intraepithelial Eosinophil Count (Eos/Hpf) in All Three Regions at Week 24 Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). A greater esophageal intraepithelial eosinophil count from baseline indicates worsening disease. Baseline and week 24
Secondary Percent Change From Baseline in DSQ Total Score at Week 24 The DSQ is used to measure the frequency and intensity of dysphagia. DSQ scores can range from 0 to 84, with a lower score indicating less-frequent or less-severe dysphagia. Baseline and week 24
Secondary Absolute Change From Baseline in Eosinophilic Esophagitis Histology Scoring System (EoEHSS) Mean Grade Score at Week 24 Severity (grade) and extent (stage) of esophageal abnormalities were scored by blinded, central pathologists using a 4-point scale (0 normal; 3 maximum change) for eight features: eosinophil density, basal zone hyperplasia, eosinophil abscesses, eosinophil surface layering, dilated intercellular spaces, surface epithelial alteration, dyskeratotic epithelial cells and lamina propria fibrosis (absent/present). Higher score indicates greater severity and extent of histological abnormalities. Baseline and week 24
Secondary Absolute Change From Baseline in EoEHSS Mean Stage Score at Week 24 Severity (grade) and extent (stage) of esophageal abnormalities were scored by blinded, central pathologists using a 4-point scale (0 normal; 3 maximum change) for eight features: eosinophil density, basal zone hyperplasia, eosinophil abscesses, eosinophil surface layering, dilated intercellular spaces, surface epithelial alteration, dyskeratotic epithelial cells and lamina propria fibrosis (absent/present). Higher score indicates greater severity and extent of histological abnormalities. Baseline and week 24
Secondary Absolute Change From Baseline in EoE Endoscopic Reference Total Score (EoE-EREFS) at Week 24 EoE esophageal characteristics analyzed based on the 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. Baseline and week 24
Secondary Percentage of Participants Achieving Peak Esophageal Intraepithelial Eosinophil Count of <15 Eos/Hpf in All Three Regions at Week 24 Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). At week 24
Secondary Normalized Enrichment Score (NES) for the Relative Change From Baseline in the EoE Diagnostic Panel (EDP) at Week 24 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). Baseline and week 24
Secondary NES for the Relative Change From Baseline in the Type 2 Inflammation Signature (T2INF) at Week 24 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). Baseline and week 24
Secondary Percentage of Participants Achieving Peak Esophageal Intraepithelial Eosinophil Count of =1 Eos/Hpf in All Three Regions at Week 24 Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). At week 24
Secondary Absolute Change From Baseline in Health-related Quality of Life (QoL) Average Score as Measured by EoE Impact Questionnaire (EoE-IQ) at Week 24 The EoE-IQ measures impact of EoE on emotional, social, work & school, & sleep aspects. Participants were asked to respond to 11 questions based on experience living with EoE during past 7 days. Response to each item is on a 5-point scale (1=Not at all [impacted] 2=A little, 3=Somewhat, 4=Quite a bit, 5=Extremely [impacted]). The average score is the sum of non-missing responses divided by the number of items with non-missing responses. The average score can range from 1 to 5; a higher score is indicative of a more negative impact. Baseline and week 24
Secondary Absolute Change From Baseline in Severity of EoE Symptoms Other Than Dysphagia as Measured by EoE Symptom Questionnaire (EoE-SQ) at Week 24 The EoE-SQ asks about symptoms that participants with EoE may have (chest pain, stomach pain, burning feeling in chest, food or liquid coming back up into throat, throwing up) during the past 7 days. Response to the severity of each symptom based on the worst experience in the past 7 days is on a scale of 0 to 10 (higher is worse). The EoE-SQ severity score is calculated as the sum of the severity scores from questions 1 to 3 (chest pain, stomach pain, burning feeling in chest), which could range from 0 to 30; a higher score is indicative of more severe symptoms. Baseline and week 24
Secondary Absolute Change From Baseline in Frequency of EoE Symptoms Other Than Dysphagia as Measured by EoE-SQ at Week 24 The EoE-SQ asks about symptoms that participants with EoE may have (chest pain, stomach pain, burning feeling in chest, food or liquid coming back up into throat, throwing up) during the past 7 days. Response to the frequency of each symptom is on a 5-point scale (1 = 'Never', 2 = 'One day', 3 = ' 2-6 days', 4 = 'Once a day', 5 = 'More than once a day'). The EoE-SQ frequency score is calculated as the sum of the frequency scores from the 5 items which could range from 5 to 25; a higher score is indicative of higher frequency of symptoms. Baseline and week 24
Secondary Percentage of Participants Who Received Rescue Treatment During the Placebo-controlled, Double-blind Treatment Period at Week 24 At week 24
Secondary Absolute Change From Baseline in Esophageal Distensibility Plateau Measured by Functional Lumen Imaging, if Collected, at Week 24 At week 24
Secondary Percentage of Participants Achieving Peak Esophageal Intraepithelial Eosinophil Count of =6 Eosinophils Per High-power Field (Eos/Hpf) in All Three Regions at Week 52 Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). At week 52
Secondary Absolute Change in Dysphagia Symptom Questionnaire (DSQ) Total Score at Week 52 The DSQ is used to measure the frequency and intensity of dysphagia. DSQ scores can range from 0 to 84, with a lower score indicating less-frequent or less-severe dysphagia. Baseline (of previous study part) and week 52
Secondary Percent Change in DSQ Total Score at Week 52 The DSQ is used to measure the frequency and intensity of dysphagia. DSQ scores can range from 0 to 84, with a lower score indicating less-frequent or less-severe dysphagia. Baseline (of previous study part) and week 52
Secondary Absolute Change in EoE Endoscopic Reference Total Score (EoE-EREFS) at Week 52 EoE esophageal characteristics analyzed based on the 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. Baseline (of previous study part) and week 52
Secondary Percent Change in Peak Esophageal Intraepithelial Eosinophil Count (Eos/Hpf) in All Three Regions at Week 52 Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). A greater esophageal intraepithelial eosinophil count from baseline indicates worsening disease. Baseline (of previous study part) and week 52
Secondary Absolute Change in EoE Histology Scoring System (EoEHSS) Mean Grade Score at Week 52 Severity (grade) and extent (stage) of esophageal abnormalities were scored by blinded, central pathologists using a 4-point scale (0 normal; 3 maximum change) for eight features: eosinophil density, basal zone hyperplasia, eosinophil abscesses, eosinophil surface layering, dilated intercellular spaces, surface epithelial alteration, dyskeratotic epithelial cells and lamina propria fibrosis (absent/present). Higher score indicates greater severity and extent of histological abnormalities. Baseline (of previous study part) and week 52
Secondary Absolute Change in EoEHSS Mean Stage Score at Week 52 Severity (grade) and extent (stage) of esophageal abnormalities were scored by blinded, central pathologists using a 4-point scale (0 normal; 3 maximum change) for eight features: eosinophil density, basal zone hyperplasia, eosinophil abscesses, eosinophil surface layering, dilated intercellular spaces, surface epithelial alteration, dyskeratotic epithelial cells and lamina propria fibrosis (absent/present). Higher score indicates greater severity and extent of histological abnormalities. Baseline (of previous study part) and week 52
Secondary Percentage of Participants Achieving Peak Esophageal Intraepithelial Eosinophil Count of <15 Eos/Hpf in All Three Regions at Week 52 Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). At week 52
Secondary Percentage of Participants Achieving Peak Esophageal Intraepithelial Eosinophil Count of =1 Eos/Hpf in All Three Regions at Week 52 Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). At week 52
Secondary Absolute Change in Health-related QOL as Measured by EoE-IQ at Week 52 The EoE-IQ measures impact of EoE on emotional, social, work & school, & sleep aspects. Participants were asked to respond to 11 questions based on experience living with EoE during past 7 days. Response to each item is on a 5-point scale (1=Not at all [impacted] 2=A little, 3=Somewhat, 4=Quite a bit, 5=Extremely [impacted]). The average score is the sum of non-missing responses divided by the number of items with non-missing responses. The average score can range from 1 to 5; a higher score is indicative of a more negative impact. Baseline (of previous study part) and week 52
Secondary Absolute Change From Baseline in Severity of EoE Symptoms Other Than Dysphagia as Measured by EoE-SQ at Week 52 The EoE-SQ asks about symptoms that participants with EoE may have (chest pain, stomach pain, burning feeling in chest, food or liquid coming back up into throat, throwing up) during the past 7 days. Response to the severity of each symptom based on the worst experience in the past 7 days is on a scale of 0 to 10 (higher is worse). The EoE-SQ severity score is calculated as the sum of the severity scores from questions 1 to 3 (chest pain, stomach pain, burning feeling in chest), which could range from 0 to 30; a higher score is indicative of more severe symptoms. Baseline (of previous study part) and week 52
Secondary Absolute Change From Baseline in Frequency of EoE Symptoms Other Than Dysphagia as Measured by EoE-SQ at Week 52 The EoE-SQ asks about symptoms that participants with EoE may have (chest pain, stomach pain, burning feeling in chest, food or liquid coming back up into throat, throwing up) during the past 7 days. Response to the frequency of each symptom is on a 5-point scale (1 = 'Never', 2 = 'One day', 3 = ' 2-6 days', 4 = 'Once a day', 5 = 'More than once a day'). The EoE-SQ frequency score is calculated as the sum of the frequency scores from the 5 items which could range from 5 to 25; a higher score is indicative of higher frequency of symptoms. Baseline (of previous study part) and week 52
Secondary Percentage of Participants Who Received Rescue Medication During the 28-week Extended Active Treatment Period Baseline (of Part C) to week 28
Secondary NES for the Relative Change From Baseline in EoE Diagnostic Panel (EDP) at Week 52 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). Baseline (of previous study part) and week 52
Secondary NES for the Relative Change in the Type 2 Inflammation Signature (T2INF) at Week 52 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). Baseline (of previous study part) and week 52
Secondary Concentration of Functional Dupilumab in Serum at Week 52 Baseline (of Part C) up to week 52
Secondary Incidence of Treatment-emergent Anti-drug Antibody (ADA) Response Number of treatment-emergent ADA responses to dupilumab reported. Baseline (of previous study part) up to week 52
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