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    Clinical Trial Results:
    A Phase 3, Randomized, 3-Part Study to Investigate the Efficacy and Safety of Dupilumab in Adult and Adolescent Patients with Eosinophilic Esophagitis (EoE)

    Summary
    EudraCT number
    2018-000844-25
    Trial protocol
    DE   FR   SE   GB   NL   PT   BE   IT   ES  
    Global end of trial date
    07 Jun 2022

    Results information
    Results version number
    v1(current)
    This version publication date
    22 Dec 2022
    First version publication date
    22 Dec 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    R668-EE-1774
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03633617
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Regeneron Pharmaceuticals, Inc.
    Sponsor organisation address
    777 Old Saw Mill River Rd., Tarrytown, NY, United States, 10591
    Public contact
    Clinical Trials Administrator, Regeneron Pharmaceuticals, Inc., 001 8447346643, clinicaltrials@regeneron.com
    Scientific contact
    Clinical Trials Administrator, Regeneron Pharmaceuticals, Inc., 001 8447346643, clinicaltrials@regeneron.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-001501-PIP04-19
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    07 Jun 2022
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    07 Jun 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    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. (Participants enrolled in Part A may not participate in 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.
    Protection of trial subjects
    It is the responsibility of both the sponsor and the investigators to ensure that this clinical study will be conducted in accordance with the ethical principles that have their origin in the Declaration of Helsinki, and that are consistent with the International Council for Harmonisation (ICH) guidelines for Good Clinical Practice (GCP) and applicable regulatory requirements.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    24 Sep 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 10
    Country: Number of subjects enrolled
    Belgium: 3
    Country: Number of subjects enrolled
    Canada: 9
    Country: Number of subjects enrolled
    Germany: 3
    Country: Number of subjects enrolled
    Spain: 9
    Country: Number of subjects enrolled
    France: 1
    Country: Number of subjects enrolled
    United Kingdom: 2
    Country: Number of subjects enrolled
    Italy: 7
    Country: Number of subjects enrolled
    Netherlands: 4
    Country: Number of subjects enrolled
    Sweden: 1
    Country: Number of subjects enrolled
    United States: 272
    Worldwide total number of subjects
    321
    EEA total number of subjects
    28
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    99
    Adults (18-64 years)
    220
    From 65 to 84 years
    2
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Part A (24-week double-blind treatment period [DBTP]):157 participants screened, 81 randomized and received at least 1 dose of study drug; Part B (24-week DBTP): 462 participants screened, 240 randomized, 239 received treatment (1 participant randomized to placebo did not meet eligibility criteria and was discontinued prior to being treated).

    Period 1
    Period 1 title
    Double-blind, placebo-controlled
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Part A: Placebo
    Arm description
    Participants received placebo matching dupilumab subcutaneously (SC) during Part A (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part A entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.
    Arm type
    Placebo

    Investigational medicinal product name
    placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Placebo matching dupilumab

    Arm title
    Part A: Dupilumab 300 mg QW
    Arm description
    Participants received dupilumab 300 milligrams (mg) SC once per week (QW) during Part A (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part A entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.
    Arm type
    Experimental

    Investigational medicinal product name
    dupilumab
    Investigational medicinal product code
    REGN668
    Other name
    DUPIXENT
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Dupilumab 300 mg delivered subcutaneously (SC) once weekly (QW)

    Arm title
    Part B: Placebo
    Arm description
    Participants received placebo matching dupilumab SC during Part B (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part B entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.
    Arm type
    Placebo

    Investigational medicinal product name
    placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Placebo matching dupilumab

    Arm title
    Part B: Dupilumab 300 mg Q2W
    Arm description
    Participants received dupilumab 300 mg once every 2 weeks (Q2W) SC during Part B (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part B entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.
    Arm type
    Experimental

    Investigational medicinal product name
    dupilumab
    Investigational medicinal product code
    REGN668
    Other name
    DUPIXENT
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Dupilumab 300 mg delivered subcutaneously (SC) once every 2 weeks (Q2W); a SC injection of placebo was delivered in between dupilumab doses to maintain injection frequency between groups.

    Arm title
    Part B: Dupilumab 300 mg QW
    Arm description
    Participants received dupilumab 300 mg SC once per week (QW) during Part B (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part B entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.
    Arm type
    Experimental

    Investigational medicinal product name
    dupilumab
    Investigational medicinal product code
    REGN668
    Other name
    DUPIXENT
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Dupilumab 300 mg delivered subcutaneously (SC) once weekly (QW)

    Number of subjects in period 1
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Started
    39
    42
    79
    81
    80
    Completed week 24 (Part A ; Part B)
    37
    40
    74
    79
    75
    Completed
    37
    40
    74
    79
    75
    Not completed
    2
    2
    5
    2
    5
         COVID-19 Restrictions
    -
    -
    1
    -
    -
         Consent withdrawn by subject
    -
    1
    1
    -
    2
         Physician decision
    -
    -
    -
    -
    1
         Adverse event, non-fatal
    -
    1
    2
    2
    1
         Unconfirmed early termination visit
    1
    -
    -
    -
    -
         Pregnancy
    1
    -
    -
    -
    -
         Lost to follow-up
    -
    -
    -
    -
    1
         Randomized, but no study drug (did not qualify)
    -
    -
    1
    -
    -
    Period 2
    Period 2 title
    Extended active treatment & follow-up
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Assessor
    Blinding implementation details
    Only participants entering Part C from Part B were blinded to treatment regimen in Part C.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Part A/C: Placebo / Dupilumab 300 mg QW
    Arm description
    Participants randomized to placebo in Part A, received dupilumab 300 mg QW for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.
    Arm type
    Experimental

    Investigational medicinal product name
    dupilumab
    Investigational medicinal product code
    REGN668
    Other name
    DUPIXENT
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Dupilumab 300 mg delivered subcutaneously (SC) once weekly (QW)

    Arm title
    Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Arm description
    Participants randomized to dupilumab 300 mg QW in Part A continued to receive the same regimen for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.
    Arm type
    Experimental

    Investigational medicinal product name
    dupilumab
    Investigational medicinal product code
    REGN668
    Other name
    DUPIXENT
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Dupilumab 300 mg delivered subcutaneously (SC) once weekly (QW)

    Arm title
    Part B/C: Placebo / Dupilumab 300 mg Q2W
    Arm description
    Participants randomized to placebo in Part B were re-randomized in a 1:1 ratio to receive dupilumab 300 mg Q2W for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.
    Arm type
    Experimental

    Investigational medicinal product name
    dupilumab
    Investigational medicinal product code
    REGN668
    Other name
    DUPIXENT
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Dupilumab 300 mg delivered subcutaneously (SC) once every 2 weeks (Q2W); a SC injection of placebo was delivered in between dupilumab doses to maintain injection frequency between groups.

    Arm title
    Part B/C: Placebo / Dupilumab 300 mg QW
    Arm description
    Participants randomized to placebo in Part B were re-randomized in a 1:1 ratio to receive dupilumab 300 mg QW for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.
    Arm type
    Experimental

    Investigational medicinal product name
    dupilumab
    Investigational medicinal product code
    REGN668
    Other name
    DUPIXENT
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Dupilumab 300 mg delivered subcutaneously (SC) once weekly (QW)

    Arm title
    Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W
    Arm description
    Participants randomized to dupilumab 300 mg Q2W in Part B continued to receive the same regimen for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.
    Arm type
    Experimental

    Investigational medicinal product name
    dupilumab
    Investigational medicinal product code
    REGN668
    Other name
    DUPIXENT
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Dupilumab 300 mg delivered subcutaneously (SC) once every 2 weeks (Q2W); a SC injection of placebo was delivered in between dupilumab doses to maintain injection frequency between groups.

    Arm title
    Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Arm description
    Participants randomized to dupilumab 300 mg QW during Part B, continued to receive the same regimen for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.
    Arm type
    Experimental

    Investigational medicinal product name
    dupilumab
    Investigational medicinal product code
    REGN668
    Other name
    DUPIXENT
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Dupilumab 300 mg delivered subcutaneously (SC) once weekly (QW)

    Number of subjects in period 2 [1]
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Started
    37
    40
    37
    37
    79
    74
    Completed week 52 treatment (Part C)
    32
    38
    34
    36
    74
    65
    Completed
    30
    35
    33
    36
    67
    64
    Not completed
    7
    5
    4
    1
    12
    10
         Consent withdrawn by subject
    2
    2
    -
    1
    1
    6
         Physician decision
    -
    -
    1
    -
    -
    1
         Adverse event, non-fatal
    1
    -
    1
    -
    -
    -
         Pregnancy
    -
    -
    -
    -
    1
    -
         COVID-19 related
    1
    -
    -
    -
    -
    -
         Lost to follow-up
    3
    3
    1
    -
    7
    2
         Lack of efficacy
    -
    -
    1
    -
    -
    -
         Protocol deviation
    -
    -
    -
    -
    3
    1
    Notes
    [1] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period.
    Justification: One participant's week 24 visit in Part A was delayed due to COVID-19; afterwards, participant moved to Part C

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Part A: Placebo
    Reporting group description
    Participants received placebo matching dupilumab subcutaneously (SC) during Part A (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part A entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group title
    Part A: Dupilumab 300 mg QW
    Reporting group description
    Participants received dupilumab 300 milligrams (mg) SC once per week (QW) during Part A (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part A entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group title
    Part B: Placebo
    Reporting group description
    Participants received placebo matching dupilumab SC during Part B (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part B entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group title
    Part B: Dupilumab 300 mg Q2W
    Reporting group description
    Participants received dupilumab 300 mg once every 2 weeks (Q2W) SC during Part B (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part B entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group title
    Part B: Dupilumab 300 mg QW
    Reporting group description
    Participants received dupilumab 300 mg SC once per week (QW) during Part B (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part B entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW Total
    Number of subjects
    39 42 79 81 80 321
    Age Categorical
    Age
    Units: Participants
        ≥ 12 to < 18 years old
    9 11 26 27 26 99
        ≥ 18 to < 40 years old
    22 13 38 35 38 146
        ≥ 40 to < 65 years old
    8 18 15 18 15 74
        ≥ 65 years old
    0 0 0 1 1 2
    Sex: Female, Male
    Units: Participants
        Female
    18 14 21 36 30 119
        Male
    21 28 58 45 50 202
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    1 4 5 3 5 18
        Not Hispanic or Latino
    38 38 74 77 75 302
        Unknown or Not Reported
    0 0 0 1 0 1
    Race/Ethnicity, Customized
    Race
    Units: Subjects
        White
    37 41 72 74 71 295
        Black or African American
    1 1 3 3 2 10
        Asian
    0 0 1 1 3 5
        Other
    1 0 2 2 3 8
        Not reported
    0 0 1 1 1 3
    Dysphagia Symptom Questionnaire (DSQ) Total Score
    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.
    Units: Score on a Scale
        arithmetic mean (standard deviation)
    35.1 ( 12.11 ) 32.2 ( 12.66 ) 36.1 ( 10.55 ) 35.6 ( 12.24 ) 38.4 ( 10.70 ) -
    Peak Eosinophils (eos) Count of Three Regions per High-power Field (/hpf)
    Units: Eosinophils/high-power field (eos/hpf)
        arithmetic mean (standard deviation)
    96.5 ( 54.69 ) 82.6 ( 41.02 ) 84.3 ( 41.20 ) 87.7 ( 49.37 ) 89.2 ( 46.67 ) -
    Eosinophilic Esophagitis (EoE) Histological Grade Calculated Mean Score (0 - 3)
    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.
    Units: Score on a Scale
        arithmetic mean (standard deviation)
    1.324 ( 0.4676 ) 1.260 ( 0.4088 ) 1.226 ( 0.3996 ) 1.245 ( 0.3721 ) 1.305 ( 0.3882 ) -
    Eosinophilic Esophagitis (EoE) Histological Stage Calculated Mean Score (0 - 3)
    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.
    Units: Score on a Scale
        arithmetic mean (standard deviation)
    1.376 ( 0.3972 ) 1.299 ( 0.3334 ) 1.216 ( 0.3608 ) 1.248 ( 0.3182 ) 1.294 ( 0.3256 ) -

    End points

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    End points reporting groups
    Reporting group title
    Part A: Placebo
    Reporting group description
    Participants received placebo matching dupilumab subcutaneously (SC) during Part A (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part A entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group title
    Part A: Dupilumab 300 mg QW
    Reporting group description
    Participants received dupilumab 300 milligrams (mg) SC once per week (QW) during Part A (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part A entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group title
    Part B: Placebo
    Reporting group description
    Participants received placebo matching dupilumab SC during Part B (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part B entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group title
    Part B: Dupilumab 300 mg Q2W
    Reporting group description
    Participants received dupilumab 300 mg once every 2 weeks (Q2W) SC during Part B (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part B entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group title
    Part B: Dupilumab 300 mg QW
    Reporting group description
    Participants received dupilumab 300 mg SC once per week (QW) during Part B (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part B entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.
    Reporting group title
    Part A/C: Placebo / Dupilumab 300 mg QW
    Reporting group description
    Participants randomized to placebo in Part A, received dupilumab 300 mg QW for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.

    Reporting group title
    Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Reporting group description
    Participants randomized to dupilumab 300 mg QW in Part A continued to receive the same regimen for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.

    Reporting group title
    Part B/C: Placebo / Dupilumab 300 mg Q2W
    Reporting group description
    Participants randomized to placebo in Part B were re-randomized in a 1:1 ratio to receive dupilumab 300 mg Q2W for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.

    Reporting group title
    Part B/C: Placebo / Dupilumab 300 mg QW
    Reporting group description
    Participants randomized to placebo in Part B were re-randomized in a 1:1 ratio to receive dupilumab 300 mg QW for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.

    Reporting group title
    Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W
    Reporting group description
    Participants randomized to dupilumab 300 mg Q2W in Part B continued to receive the same regimen for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.

    Reporting group title
    Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Reporting group description
    Participants randomized to dupilumab 300 mg QW during Part B, continued to receive the same regimen for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.

    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

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    End point title
    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
    End point description
    Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). Part A Full Analysis Set (FAS): All participants randomized to Part A (Participants considered non-responder after rescue treatment use and multiple imputation (MI) method for missing due to COVID-19; Participants considered non-responder for missing not due to COVID-19); Part B FAS: All participants randomized to Part B (Participants considered non-responder after rescue treatment use or missing not due to COVID-19 and MI method for missing or dosing interruption due to COVID-19)
    End point type
    Primary
    End point timeframe
    At week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    79
    81
    80
    Units: Percentage of Participants
        number (confidence interval 95%)
    5.1 (0.63 to 17.32)
    59.5 (43.28 to 74.37)
    6.3 (2.09 to 14.16)
    60.5 (49.01 to 71.19)
    58.8 (47.18 to 69.65)
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Difference is dupilumab minus placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in proportion
    Point estimate
    55.3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    39.58
         upper limit
    71.04
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Difference is dupilumab minus placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in proportion
    Point estimate
    56
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    43.44
         upper limit
    68.54
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Difference is dupilumab minus placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    159
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in proportion
    Point estimate
    53.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    41.2
         upper limit
    65.79

    Primary: Absolute change from baseline in Dysphagia Symptom Questionnaire (DSQ) total score at week 24

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    End point title
    Absolute change from baseline in Dysphagia Symptom Questionnaire (DSQ) total score at week 24
    End point description
    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. Part A Full Analysis Set (FAS): All participant randomized to Part A (MI method for missing data or data set to missing after rescue treatment use); Part B FAS: All participants randomized to Part B (MI method for missing data or data set to missing after rescue treatment use)
    End point type
    Primary
    End point timeframe
    Baseline and week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    79
    81
    80
    Units: Score on a Scale
        least squares mean (confidence interval 95%)
    -9.60 (-15.056 to -4.136)
    -21.92 (-26.870 to -16.967)
    -13.86 (-17.605 to -10.120)
    -14.37 (-18.018 to -10.723)
    -23.78 (-27.427 to -20.131)
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab group vs. Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0004
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -12.32
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -19.107
         upper limit
    -5.537
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab group vs. Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    159
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -9.92
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -14.811
         upper limit
    -5.022
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Dupilumab group vs. Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.8393
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -0.51
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -5.423
         upper limit
    4.406

    Secondary: Percent change from baseline in peak esophageal intraepithelial eosinophil count (eos/hpf) in all three regions at week 24

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    End point title
    Percent change from baseline in peak esophageal intraepithelial eosinophil count (eos/hpf) in all three regions at week 24
    End point description
    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. Part A FAS (Worst-observation carried forward [WOCF]-MI method with WOCF for rescue treatment use and missing not due to COVID-19; MI method for missing due to COVID-19); Part B FAS (WOCF-MI method with WOCF for rescue treatment use and missing not due to COVID-19 and MI method for missing or dosing interruption due to COVID-19)
    End point type
    Secondary
    End point timeframe
    Baseline and week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    79
    81
    80
    Units: Percentage of Change
        least squares mean (confidence interval 95%)
    -2.98 (-17.886 to 11.921)
    -71.24 (-84.863 to -57.613)
    8.38 (-11.677 to 28.433)
    -70.84 (-87.095 to -54.585)
    -80.24 (-96.589 to -63.895)
    Statistical analysis title
    Part A: Placebo; Part A: Dupilumab 300 mg QW
    Statistical analysis description
    Dupilumab 300 mg QW vs Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -68.26
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -86.896
         upper limit
    -49.615
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab 300 mg QW vs Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    159
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -88.62
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -112.194
         upper limit
    -65.046
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Dupilumab 300 mg Q2W vs Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -79.22
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -103.098
         upper limit
    -55.338

    Secondary: Percent change from baseline in DSQ total score at week 24

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    End point title
    Percent change from baseline in DSQ total score at week 24
    End point description
    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. Part A FAS (MI method for missing data or data set to missing after rescue treatment use); Part B FAS (MI method for missing data or data set to missing after rescue treatment use)
    End point type
    Secondary
    End point timeframe
    Baseline and week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    79
    81
    80
    Units: Percentage of Change
        least squares mean (confidence interval 95%)
    -31.68 (-47.545 to -15.818)
    -69.17 (-83.578 to -54.752)
    -41.43 (-51.749 to -31.116)
    -45.78 (-55.658 to -35.904)
    -64.32 (-74.267 to 54.382)
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab 300 mg QW vs Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0002
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -37.48
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -57.222
         upper limit
    -17.745
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Dupilumab 300 mg Q2W vs Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.5243
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -4.35
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -17.734
         upper limit
    9.038
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab 300 mg QW vs Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    159
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0008
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -22.89
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -36.272
         upper limit
    -9.513

    Secondary: Absolute change from baseline in Eosinophilic Esophagitis Histology Scoring System (EoEHSS) mean Grade score at week 24

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    End point title
    Absolute change from baseline in Eosinophilic Esophagitis Histology Scoring System (EoEHSS) mean Grade score at week 24
    End point description
    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. Part A FAS (WOCF-MI method with WOCF for rescue treatment use and missing not due to COVID-19; MI method for missing due to COVID-19); Part B FAS (WOCF-MI method with WOCF for rescue treatment use and missing not due to COVID-19 and MI method for missing or dosing interruption due to COVID-19)
    End point type
    Secondary
    End point timeframe
    Baseline and week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    79
    81
    80
    Units: Score on a Scale
        least squares mean (confidence interval 95%)
    -0.001 (-0.1166 to 0.1139)
    -0.761 (-0.8732 to -0.6484)
    -0.148 (-0.2379 to -0.0584)
    -0.814 (-0.8958 to -0.7317)
    -0.830 (-0.9136 to -0.7463)
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab 300 mg QW vs Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -0.759
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.9061
         upper limit
    -0.6127
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab 300 mg QW vs Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    159
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -0.682
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.7929
         upper limit
    -0.5707
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Dupilumab 300 mg Q2W vs Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -0.666
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.7773
         upper limit
    -0.5538

    Secondary: Absolute change from baseline in EoEHSS mean Stage score at week 24

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    End point title
    Absolute change from baseline in EoEHSS mean Stage score at week 24
    End point description
    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. Part A FAS (WOCF-MI method with WOCF for rescue treatment use and missing not due to COVID-19; MI method for missing due to COVID-19); Part B FAS (WOCF-MI Method with WOCF for Rescue Treatment Use and Missing Not Due to COVID-19 and MI Method for Missing or Dosing Interruption Due to COVID-19)
    End point type
    Secondary
    End point timeframe
    Baseline and week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    79
    81
    80
    Units: Score on a Scale
        least squares mean (confidence interval 95%)
    -0.012 (-0.1243 to 0.0995)
    -0.753 (-0.8627 to -0.6441)
    -0.132 (-0.2179 to -0.0464)
    -0.793 (-0.8713 to -0.7144)
    -0.804 (-0.8839 to -0.7237)
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab 300 mg QW vs Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -0.741
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.8842
         upper limit
    -0.5978
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab 300 mg QW vs Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    159
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -0.672
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.7778
         upper limit
    -0.5655
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Dupilumab 300 mg Q2W vs Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -0.661
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.7674
         upper limit
    -0.554

    Secondary: Absolute change from baseline in EoE Endoscopic Reference total Score (EoE-EREFS) at week 24

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    End point title
    Absolute change from baseline in EoE Endoscopic Reference total Score (EoE-EREFS) at week 24
    End point description
    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. Part A FAS (WOCF-MI method with WOCF for rescue treatment use and missing not due to COVID-19; MI method for missing due to COVID-19); Part B FAS (WOCF-MI Method with WOCF for Rescue Treatment Use and Missing Not Due to COVID-19 and MI Method for Missing or Dosing Interruption Due to COVID-19)
    End point type
    Secondary
    End point timeframe
    Baseline and week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    79
    81
    80
    Units: Score on a Scale
        least squares mean (confidence interval 95%)
    -0.3 (-1.11 to 0.50)
    -3.2 (-3.98 to -2.38)
    -0.6 (-1.37 to 0.12)
    -4.6 (-5.24 to -3.89)
    -4.5 (-5.17 to -3.77)
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab 300 mg QW vs Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -2.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -3.91
         upper limit
    -1.84
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab 300 mg QW vs Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    159
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -3.8
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -4.77
         upper limit
    -2.93
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Dupilumab 300 mg Q2W vs Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -3.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -4.86
         upper limit
    -3.02

    Secondary: Percentage of participants achieving peak esophageal intraepithelial eosinophil count of <15 eos/hpf in all three regions at week 24

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    End point title
    Percentage of participants achieving peak esophageal intraepithelial eosinophil count of <15 eos/hpf in all three regions at week 24
    End point description
    Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). Part A FAS (Participants considered non-responder after rescue treatment use and MI method for missing due to COVID-19; Participants considered non-responder for missing not due to COVID-19); Part B FAS (Participants considered non-responder after rescue treatment use or missing not due to COVID-19 and MI method for missing or dosing interruption due to COVID-19).
    End point type
    Secondary
    End point timeframe
    At week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    79
    81
    80
    Units: Percentage of Participants
        number (confidence interval 95%)
    7.7 (1.62 to 20.87)
    64.3 (48.03 to 78.45)
    7.6 (2.84 to 15.80)
    79.0 (68.54 to 87.27)
    82.5 (72.38 to 90.09)
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Difference is Dupilumab minus Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in proportion
    Point estimate
    57.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    41.69
         upper limit
    73.33
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Difference is Dupilumab minus Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    159
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in proportion
    Point estimate
    74.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    64.25
         upper limit
    85.5
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Difference is Dupilumab minus Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in proportion
    Point estimate
    72.4
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    61.05
         upper limit
    83.7

    Secondary: Normalized Enrichment Score (NES) for the relative change from baseline in EoE Diagnostic Panel (EDP) at week 24

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    End point title
    Normalized Enrichment Score (NES) for the relative change from baseline in EoE Diagnostic Panel (EDP) at week 24
    End point description
    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. A 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). Part A FAS (Participants with NES Score in Part A; Last observation carried forward [LOCF] method with data set to missing after rescue treatment use); Part B FAS (Participants with NES Score in Part B; LOCF method with data set to missing after rescue treatment use)
    End point type
    Secondary
    End point timeframe
    Baseline and week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    29
    31
    41
    44
    40
    Units: Score on a Scale
        median (not applicable)
    -0.160 ( 99999 )
    -2.660 ( 99999 )
    -0.730 ( 99999 )
    -2.675 ( 99999 )
    -2.665 ( 99999 )
    Statistical analysis title
    Part B:Placebo, Part B:Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Median Difference is Dupilumab minus Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    85
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Wilcoxon rank-sum test
    Parameter type
    Hodges-Lehmann estimator
    Point estimate
    -1.84
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.42
         upper limit
    -1.11
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Median Difference is Dupilumab minus Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    60
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Wilcoxon rank-sum test
    Parameter type
    Hodges-Lehmann estimator
    Point estimate
    -2.25
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.72
         upper limit
    -1.73
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Median Difference is Dupilumab minus Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Wilcoxon rank-sum test
    Parameter type
    Hodges-Lehmann estimator
    Point estimate
    -1.85
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.44
         upper limit
    -1.15

    Secondary: NES for the relative change from baseline in type 2 inflammation signature at week 24

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    End point title
    NES for the relative change from baseline in type 2 inflammation signature at week 24
    End point description
    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. A 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). Part A FAS (Participants with NES Score in Part A; LOCF Method with data set to missing after rescue treatment use); Part B FAS (Participants with NES Score in Part B; LOCF method with data set to missing after rescue treatment use)
    End point type
    Secondary
    End point timeframe
    Baseline and week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    29
    31
    41
    44
    40
    Units: Score on a Scale
        median (not applicable)
    -0.320 ( 99999 )
    -1.970 ( 99999 )
    -0.640 ( 99999 )
    -1.950 ( 99999 )
    -1.930 ( 99999 )
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Median Difference is Dupilumab minus Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    60
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Wilcoxon rank-sum test
    Parameter type
    Hodges-Lehmann estimator
    Point estimate
    -1.59
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.74
         upper limit
    -1.27
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Median Difference is Dupilumab minus Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Wilcoxon rank-sum test
    Parameter type
    Hodges-Lehmann estimator
    Point estimate
    -1.275
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.82
         upper limit
    -1.07
    Statistical analysis title
    Part B:Placebo, Part B:Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Median Difference is Dupilumab minus Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    85
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Wilcoxon rank-sum test
    Parameter type
    Hodges-Lehmann estimator
    Point estimate
    -1.255
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.73
         upper limit
    -1.05

    Secondary: Percentage of participants achieving peak esophageal intraepithelial eosinophil count of ≤1 eos/hpf in all three regions at week 24

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    End point title
    Percentage of participants achieving peak esophageal intraepithelial eosinophil count of ≤1 eos/hpf in all three regions at week 24
    End point description
    Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). Part A FAS (Participants considered non-responder after rescue treatment use and MI method for missing due to COVID-19; Participants considered non-responder for missing not due to COVID-19); Part B FAS (Participants considered non-responder after rescue treatment use or missing not due to COVID-19 and MI method for missing or dosing interruption due to COVID-19)
    End point type
    Secondary
    End point timeframe
    At week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    79
    81
    80
    Units: Percentage of Participants
        number (confidence interval 95%)
    0.0 (0.00 to 9.03)
    21.4 (10.30 to 36.81)
    1.3 (0.03 to 6.85)
    27.2 (17.87 to 38.19)
    28.8 (19.18 to 39.95)
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Difference is Dupilumab minus Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0017
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in proportion
    Point estimate
    21.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    9.42
         upper limit
    34.38
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Difference is Dupilumab minus Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    159
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in proportion
    Point estimate
    28.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    18.36
         upper limit
    39.46
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Difference is Dupilumab minus Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in proportion
    Point estimate
    27.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    17.2
         upper limit
    38.09

    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

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    End point title
    Absolute change from baseline in health-related quality of life (QOL) average score as measured by EoE Impact Questionnaire (EoE-IQ) at week 24
    End point description
    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. Part A FAS (MI method with data set to missing after rescue treatment use); Part B FAS (MI method with data set to missing after rescue treatment use)
    End point type
    Secondary
    End point timeframe
    Baseline and week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    79
    81
    80
    Units: Score on a Scale
        least squares mean (confidence interval 95%)
    -0.246 (-0.4659 to -0.0266)
    -0.614 (-0.8140 to -0.4149)
    -0.578 (-0.6977 to -0.4585)
    -0.593 (-0.7152 to -0.4706)
    -0.887 (-1.0050 to -0.7685)
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab group vs Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0077
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -0.368
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.6388
         upper limit
    -0.0975
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab group vs. Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    159
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0002
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -0.309
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.4703
         upper limit
    -0.1471
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Dupilumab group vs Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.8586
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -0.015
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.1782
         upper limit
    0.1485

    Secondary: Absolute change from baseline in Severity of EoE symptoms other than dysphagia as measured by EoE Symptom Questionnaire (EoE-SQ) at week 24

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    End point title
    Absolute change from baseline in Severity of EoE symptoms other than dysphagia as measured by EoE Symptom Questionnaire (EoE-SQ) at week 24
    End point description
    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. Part A FAS (MI method with data set to missing after rescue treatment use); Part B FAS (MI method with data set to missing after rescue treatment use)
    End point type
    Secondary
    End point timeframe
    Baseline and week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    79
    81
    80
    Units: Score on a Scale
        least squares mean (confidence interval 95%)
    -3.9 (-5.46 to -2.31)
    -5.8 (-7.24 to -4.44)
    -4.0 (-5.16 to -2.80)
    -4.5 (-5.59 to -3.32)
    -5.4 (-6.60 to -4.27)
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab group vs. Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0467
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -3.87
         upper limit
    -0.03
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Dupilumab group vs. Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.5469
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -0.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.03
         upper limit
    1.08
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab group vs. Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    159
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0718
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -1.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -3
         upper limit
    0.13

    Secondary: Absolute change from baseline in Frequency of EoE symptoms other than dysphagia as measured by EoE-SQ at week 24

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    End point title
    Absolute change from baseline in Frequency of EoE symptoms other than dysphagia as measured by EoE-SQ at week 24
    End point description
    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. Part A FAS (MI method with data set to missing after rescue treatment use); Part B FAS (MI method with data set to missing after rescue treatment use)
    End point type
    Secondary
    End point timeframe
    Baseline and week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    79
    81
    80
    Units: Score on a Scale
        least squares mean (confidence interval 95%)
    -1.7 (-2.67 to -0.71)
    -3.4 (-4.29 to -2.53)
    -2.6 (-3.25 to -1.87)
    -3.0 (-3.69 to -2.36)
    -3.9 (-4.61 to -3.25)
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab group vs. Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0051
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -1.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.93
         upper limit
    -0.52
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Dupilumab group vs. Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    159
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0037
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -1.4
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.3
         upper limit
    0.45
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Dupilumab group vs. Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.3152
    Method
    ANCOVA
    Parameter type
    LS Mean Difference
    Point estimate
    -0.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.38
         upper limit
    0.44

    Secondary: Percentage of participants who received rescue medication during the 24-week double-blind, placebo-controlled treatment period

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    End point title
    Percentage of participants who received rescue medication during the 24-week double-blind, placebo-controlled treatment period
    End point description
    End point type
    Secondary
    End point timeframe
    At week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    79
    81
    80
    Units: Percentage of Participants
        number (confidence interval 95%)
    12.8 (4.30 to 27.43)
    0.0 (0.00 to 8.41)
    2.5 (0.31 to 8.85)
    1.2 (0.03 to 6.69)
    2.5 (0.30 to 8.74)
    Statistical analysis title
    Part A: Placebo, Part A: Dupilumab 300 mg SC QW
    Statistical analysis description
    Difference is Dupilumab minus Placebo
    Comparison groups
    Part A: Placebo v Part A: Dupilumab 300 mg QW
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.017
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in proportion
    Point estimate
    -12.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -23.21
         upper limit
    -2.26
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC Q2W
    Statistical analysis description
    Difference is Dupilumab minus Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg Q2W
    Number of subjects included in analysis
    160
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.5493
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in proportion
    Point estimate
    -1.3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -5.51
         upper limit
    2.93
    Statistical analysis title
    Part B: Placebo, Part B: Dupilumab 300 mg SC QW
    Statistical analysis description
    Difference is Dupilumab minus Placebo
    Comparison groups
    Part B: Placebo v Part B: Dupilumab 300 mg QW
    Number of subjects included in analysis
    159
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.9887
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in proportion
    Point estimate
    0
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -4.9
         upper limit
    5.02

    Secondary: Concentration of functional dupilumab in serum at week 24

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    End point title
    Concentration of functional dupilumab in serum at week 24
    End point description
    The PK analysis set (PKAS) for Part A included all randomized participants who received any study drug and who had at least one non-missing drug concentration result following the first dose of study drug in the corresponding study part. The PKAS for Part B included all randomized participants who received any study drug and who had at least one non-missing drug concentration result following the first dose of study drug in the corresponding study part.
    End point type
    Secondary
    End point timeframe
    Up to week 24
    End point values
    Part A: Placebo Part A: Dupilumab 300 mg QW Part B: Placebo Part B: Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg QW
    Number of subjects analysed
    39
    42
    76
    79
    76
    Units: milligrams per liter (mg/L)
    arithmetic mean (standard deviation)
        Week 0 (n=38,41,75,77,73)
    0 ( 0 )
    0 ( 0 )
    0.00553 ( 0.0479 )
    0 ( 0 )
    0 ( 0 )
        Week 12 (n=37,42,72,67,65)
    0 ( 0 )
    187 ( 63.3 )
    0.00118 ( 0.0100 )
    70.2 ( 37.7 )
    162 ( 83.7 )
        Week 24 (n=33,36,67,68,63)
    0 ( 0 )
    197 ( 71.8 )
    0 ( 0 )
    72.1 ( 46.6 )
    189 ( 98.8 )
    No statistical analyses for this end point

    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

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    End point title
    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
    End point description
    Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    At week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    30
    34
    32
    37
    73
    65
    Units: Percentage of Participants
        number (not applicable)
    60.0
    55.9
    71.9
    67.6
    74.0
    84.6
    No statistical analyses for this end point

    Secondary: Absolute change in DSQ total score at week 52

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    End point title
    Absolute change in DSQ total score at week 52
    End point description
    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. Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    Baseline (of previous study part) and week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    23
    29
    27
    24
    52
    54
    Units: Score on a Scale
        arithmetic mean (standard deviation)
    -21.71 ( 17.143 )
    -23.44 ( 16.149 )
    -23.69 ( 13.737 )
    -27.25 ( 11.457 )
    -20.87 ( 16.387 )
    -30.26 ( 15.389 )
    No statistical analyses for this end point

    Secondary: Percent change in DSQ total score at week 52

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    End point title
    Percent change in DSQ total score at week 52
    End point description
    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. Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    Baseline (of previous study part) and week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    23
    29
    27
    24
    52
    54
    Units: Percentage of Change
        arithmetic mean (standard deviation)
    -65.87 ( 49.705 )
    -75.93 ( 36.892 )
    -71.01 ( 37.256 )
    -78.13 ( 31.003 )
    -61.19 ( 44.447 )
    -80.74 ( 32.866 )
    No statistical analyses for this end point

    Secondary: Absolute change in EoE-EREFS total score at week 52

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    End point title
    Absolute change in EoE-EREFS total score at week 52
    End point description
    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. Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    Baseline (of previous study part) and week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    30
    35
    31
    37
    73
    63
    Units: Score on a Scale
        arithmetic mean (standard deviation)
    -3.9 ( 2.74 )
    -4.1 ( 3.37 )
    -4.3 ( 3.21 )
    -6.1 ( 3.60 )
    -5.2 ( 3.40 )
    -5.3 ( 2.85 )
    No statistical analyses for this end point

    Secondary: Percent change in peak esophageal intraepithelial eosinophil count (eos/hpf) in all three regions at week 52

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    End point title
    Percent change in peak esophageal intraepithelial eosinophil count (eos/hpf) in all three regions at week 52
    End point description
    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. Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    Baseline (of previous study part) and week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    30
    34
    32
    37
    73
    65
    Units: Percentage of Change
        arithmetic mean (standard deviation)
    -83.76 ( 24.996 )
    -88.59 ( 13.506 )
    -91.20 ( 13.037 )
    -84.21 ( 42.169 )
    -84.78 ( 40.973 )
    -95.85 ( 4.037 )
    No statistical analyses for this end point

    Secondary: Absolute change in EoEHSS mean Grade score at week 52

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    End point title
    Absolute change in EoEHSS mean Grade score at week 52
    End point description
    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. Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    Baseline (of previous study part) and week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    30
    34
    32
    37
    73
    65
    Units: Score on a Scale
        arithmetic mean (standard deviation)
    -0.873 ( 0.5506 )
    -0.873 ( 0.3537 )
    -0.779 ( 0.4292 )
    -0.906 ( 0.3936 )
    -0.838 ( 0.4039 )
    -0.968 ( 0.4293 )
    No statistical analyses for this end point

    Secondary: Absolute change in EoEHSS mean Stage score at week 52

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    End point title
    Absolute change in EoEHSS mean Stage score at week 52
    End point description
    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. Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    Baseline (of previous study part) and week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    30
    34
    32
    37
    73
    65
    Units: Score on a Scale
        arithmetic mean (standard deviation)
    -0.874 ( 0.4630 )
    -0.891 ( 0.2770 )
    -0.710 ( 0.3783 )
    -0.871 ( 0.3510 )
    -0.809 ( 0.3434 )
    -0.932 ( 0.3730 )
    No statistical analyses for this end point

    Secondary: Percentage of participants achieving peak esophageal intraepithelial eosinophil count of <15 eos/hpf in all three regions at week 52

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    End point title
    Percentage of participants achieving peak esophageal intraepithelial eosinophil count of <15 eos/hpf in all three regions at week 52
    End point description
    Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    At week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    30
    34
    32
    37
    73
    65
    Units: Percentage of Participants
        number (not applicable)
    70.0
    82.4
    87.5
    78.4
    83.6
    100
    No statistical analyses for this end point

    Secondary: Percentage of participants achieving peak esophageal intraepithelial eosinophil count of ≤1 eos/hpf in all three regions at week 52

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    End point title
    Percentage of participants achieving peak esophageal intraepithelial eosinophil count of ≤1 eos/hpf in all three regions at week 52
    End point description
    Esophageal intraepithelial eosinophil count obtained by esophageal endoscopy with biopsies (all 3 esophageal regions: proximal, mid, and distal). Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    At week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    30
    34
    32
    37
    73
    65
    Units: Percentage of Participants
        number (not applicable)
    26.7
    29.4
    40.6
    16.2
    31.5
    30.8
    No statistical analyses for this end point

    Secondary: Absolute change in health-related QOL average score as measured by EoE-IQ at week 52

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    End point title
    Absolute change in health-related QOL average score as measured by EoE-IQ at week 52
    End point description
    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. Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    Baseline (of previous study part) and week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    27
    27
    31
    35
    67
    56
    Units: Score on a Scale
        arithmetic mean (standard deviation)
    -0.954 ( 0.6690 )
    -0.911 ( 0.6344 )
    -1.021 ( 0.7169 )
    -0.858 ( 0.6360 )
    -0.773 ( 0.6217 )
    -0.935 ( 0.6883 )
    No statistical analyses for this end point

    Secondary: Absolute change from baseline in Severity of EoE symptoms other than dysphagia as measured by EoE-SQ at week 52

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    End point title
    Absolute change from baseline in Severity of EoE symptoms other than dysphagia as measured by EoE-SQ at week 52
    End point description
    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. Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    Baseline (of previous study part) and week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    27
    27
    32
    35
    68
    57
    Units: Score on a Scale
        arithmetic mean (standard deviation)
    -7.2 ( 6.46 )
    -5.9 ( 6.80 )
    -6.2 ( 6.42 )
    -5.9 ( 6.47 )
    -4.7 ( 5.99 )
    -6.4 ( 6.86 )
    No statistical analyses for this end point

    Secondary: Absolute change from baseline in Frequency of EoE symptoms other than dysphagia as measured by EoE-SQ at week 52

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    End point title
    Absolute change from baseline in Frequency of EoE symptoms other than dysphagia as measured by EoE-SQ at week 52
    End point description
    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. Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    Baseline (of previous study part) and week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    27
    27
    32
    35
    68
    57
    Units: Score on a Scale
        arithmetic mean (standard deviation)
    -4.3 ( 3.78 )
    -3.2 ( 3.50 )
    -4.0 ( 3.54 )
    -3.8 ( 3.62 )
    -3.6 ( 3.45 )
    -4.7 ( 4.03 )
    No statistical analyses for this end point

    Secondary: Percentage of participants who received rescue medication during the 28-week extended active treatment period

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    End point title
    Percentage of participants who received rescue medication during the 28-week extended active treatment period
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline (of Part C) to week 28
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    37
    40
    37
    37
    79
    74
    Units: Percentage of Participants
        number (not applicable)
    8.1
    0
    2.7
    2.7
    0
    1.4
    No statistical analyses for this end point

    Secondary: NES for the relative change from baseline in EoE Diagnostic Panel (EDP) at week 52

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    End point title
    NES for the relative change from baseline in EoE Diagnostic Panel (EDP) at week 52
    End point description
    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). Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    Baseline (of previous study part) and week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    27
    30
    17
    24
    60
    49
    Units: Score on a Scale
        median (full range (min-max))
    -2.580 (-2.87 to -0.45)
    -2.670 (-2.83 to -1.09)
    -2.28 (-2.8 to -0.8)
    -2.62 (-2.9 to -2.1)
    -2.64 (-2.9 to 1.2)
    -2.69 (-2.9 to -0.6)
    No statistical analyses for this end point

    Secondary: NES for the relative change in type 2 inflammation signature at week 52

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    End point title
    NES for the relative change in type 2 inflammation signature at week 52
    End point description
    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). Part C safety analysis set (SAF): All participants who were randomized in Part A/B, entered Part C, and received any study drug in Part C.
    End point type
    Secondary
    End point timeframe
    Baseline (of previous study part) and week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    27
    30
    17
    24
    60
    49
    Units: Score on a Scale
        median (full range (min-max))
    -1.940 (-2.11 to -0.42)
    -1.970 (-2.07 to -0.95)
    -1.76 (-2.1 to -1.0)
    -1.96 (-2.1 to -1.5)
    -1.95 (-2.1 to 0.3)
    -1.97 (-2.2 to -0.7)
    No statistical analyses for this end point

    Secondary: Concentration of functional dupilumab in serum at week 52

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    End point title
    Concentration of functional dupilumab in serum at week 52
    End point description
    The PK analysis set (PKAS) for Part A and Part C included all randomized participants who received any study drug and who had at least one non-missing drug concentration result following the first dose of study drug in the corresponding study part. The PKAS for Part B and Part C included all randomized participants who received any study drug and who had at least one non-missing drug concentration result following the first dose of study drug in the corresponding study part.
    End point type
    Secondary
    End point timeframe
    Baseline (of Part C) up to week 52
    End point values
    Part A/C: Placebo / Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B/C: Placebo / Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    34
    38
    36
    37
    77
    69
    Units: milligrams per liter (mg/L)
    arithmetic mean (standard deviation)
        Week 24 (n=32,36,35,37,73,64)
    0 ( 0 )
    193 ( 71.4 )
    0 ( 0 )
    1.21 ( 7.33 )
    74.6 ( 45.5 )
    199 ( 92.7 )
        Week 32 (n=28,24,31,35,71,58)
    101 ( 44.6 )
    205 ( 76.8 )
    46.0 ( 33.1 )
    124 ( 56.7 )
    74.0 ( 42.0 )
    195 ( 94.6 )
        Week 52 (n=30,37,33,37,73,66)
    137 ( 81.6 )
    152 ( 70.2 )
    58.6 ( 36.5 )
    151 ( 96.0 )
    68.9 ( 45.7 )
    176 ( 120 )
    No statistical analyses for this end point

    Secondary: Incidence of treatment-emergent anti-drug antibody (ADA) response

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    End point title
    Incidence of treatment-emergent anti-drug antibody (ADA) response
    End point description
    Number of treatment-emergent ADA responses to dupilumab reported. The ADA analysis set (AAS) for Part A and Part C included all participants who received any study drug and had at least one non-missing ADA result from the dupilumab ADA assay after first dose of the study drug in the corresponding study part (participants analyzed according to treatment actually received). The AAS for Part B and Part C included all participants who received any study drug and had at least one non-missing ADA result from the dupilumab ADA assay after first dose of the study drug in the corresponding study part (participants analyzed according to treatment actually received)..
    End point type
    Secondary
    End point timeframe
    Baseline (of previous study part) up to week 52
    End point values
    Part A: Placebo Part A/C: Placebo / Dupilumab 300 mg QW Part A: Dupilumab 300 mg QW Part A/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW Part B: Placebo Part B/C: Placebo / Dupilumab 300 mg Q2W Part B: Dupilumab 300 mg Q2W Part B/C: Placebo / Dupilumab 300 mg QW Part B: Dupilumab 300 mg QW Part B/C: Dupilumab 300 mg Q2W / Dupilumab 300 mg Q2W Part B/C: Dupilumab 300 mg QW / Dupilumab 300 mg QW
    Number of subjects analysed
    39
    35
    42
    39
    77
    36
    77
    37
    76
    77
    69
    Units: Events
        number (not applicable)
    0
    4
    0
    1
    0
    1
    2
    0
    1
    5
    0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From day of first dose up to 12 weeks after end of treatment visit
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.0
    Reporting groups
    Reporting group title
    Part A: Placebo
    Reporting group description
    Participants received placebo matching dupilumab SC during Part A (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part A entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group title
    Part B: Placebo
    Reporting group description
    Participants received placebo matching dupilumab SC during Part B (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part B entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group title
    Part B: Dupilumab 300 mg Q2W
    Reporting group description
    Participants received dupilumab 300 mg Q2W SC during Part B (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part B entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group title
    Part A: Dupilumab 300 mg QW
    Reporting group description
    Participants received dupilumab 300 mg SC QW during Part A (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part A entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group title
    Part B: Dupilumab 300 mg QW
    Reporting group description
    Participants received dupilumab 300 mg SC QW during Part B (24-week DBTP). At end of week 24 visit (one-week after last dose of study drug during DBTP), eligible participants from Part B entered into 28-week extended treatment (Part C) and 12-week follow-up. Participants who did not enter into Part C, entered follow-up period.

    Reporting group title
    Part C: Dupilumab 300 mg Q2W (placebo in Part B)
    Reporting group description
    Participants randomized to placebo in Part B were re-randomized in a 1:1 ratio to receive dupilumab 300 mg Q2W for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.

    Reporting group title
    Part C: Dupilumab 300 mg QW (placebo in Part A or B)
    Reporting group description
    Participants randomized to placebo in Part A, received dupilumab 300 mg QW for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up. Participants randomized to placebo in Part B were re-randomized in a 1:1 ratio to receive dupilumab 300 mg Q2W for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.

    Reporting group title
    Part C: Dupilumab 300 mg Q2W (Part B regimen continued)
    Reporting group description
    Participants randomized to dupilumab 300 mg Q2W in Part B continued to receive the same regimen for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.

    Reporting group title
    Part C: Dupilumab 300 mg QW (Part A or B regimen continued)
    Reporting group description
    Participants randomized to dupilumab 300 mg QW in Part A continued to receive the same regimen for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up. Participants randomized to dupilumab 300 mg QW during Part B, continued to receive the same regimen for 28-week extended treatment (Part C) followed by 12-week follow-up. Participants who did not enter into Part C, entered follow-up.

    Serious adverse events
    Part A: Placebo Part B: Placebo Part B: Dupilumab 300 mg Q2W Part A: Dupilumab 300 mg QW Part B: Dupilumab 300 mg QW Part C: Dupilumab 300 mg Q2W (placebo in Part B) Part C: Dupilumab 300 mg QW (placebo in Part A or B) Part C: Dupilumab 300 mg Q2W (Part B regimen continued) Part C: Dupilumab 300 mg QW (Part A or B regimen continued)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    2 / 39 (5.13%)
    1 / 78 (1.28%)
    2 / 81 (2.47%)
    2 / 42 (4.76%)
    5 / 80 (6.25%)
    1 / 37 (2.70%)
    3 / 74 (4.05%)
    1 / 79 (1.27%)
    4 / 114 (3.51%)
         number of deaths (all causes)
    0
    0
    0
    0
    0
    0
    0
    0
    0
         number of deaths resulting from adverse events
    Investigations
    Blood creatine phosphokinase abnormal
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    1 / 80 (1.25%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Breast cancer
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    1 / 80 (1.25%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Open globe injury
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    1 / 37 (2.70%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pregnancy, puerperium and perinatal conditions
    Abortion spontaneous
         subjects affected / exposed
    1 / 39 (2.56%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    1 / 114 (0.88%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Systemic inflammatory response syndrome
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    1 / 74 (1.35%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    1 / 42 (2.38%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    1 / 114 (0.88%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Rectal tenesmus
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    1 / 114 (0.88%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    1 / 74 (1.35%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Uterine polyp
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    1 / 42 (2.38%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Suicidal ideation
         subjects affected / exposed
    1 / 39 (2.56%)
    0 / 78 (0.00%)
    2 / 81 (2.47%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 2
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Depression suicidal
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    1 / 80 (1.25%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Mental status changes
         subjects affected / exposed
    0 / 39 (0.00%)
    1 / 78 (1.28%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Generalised anxiety disorder
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    1 / 79 (1.27%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Substance use disorder
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    1 / 79 (1.27%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Campylobacter colitis
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    1 / 80 (1.25%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia aspiration
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    1 / 80 (1.25%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    1 / 74 (1.35%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Enterocolitis infectious
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    1 / 114 (0.88%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia mycoplasmal
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    1 / 114 (0.88%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Part A: Placebo Part B: Placebo Part B: Dupilumab 300 mg Q2W Part A: Dupilumab 300 mg QW Part B: Dupilumab 300 mg QW Part C: Dupilumab 300 mg Q2W (placebo in Part B) Part C: Dupilumab 300 mg QW (placebo in Part A or B) Part C: Dupilumab 300 mg Q2W (Part B regimen continued) Part C: Dupilumab 300 mg QW (Part A or B regimen continued)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    28 / 39 (71.79%)
    41 / 78 (52.56%)
    57 / 81 (70.37%)
    26 / 42 (61.90%)
    50 / 80 (62.50%)
    19 / 37 (51.35%)
    44 / 74 (59.46%)
    47 / 79 (59.49%)
    62 / 114 (54.39%)
    Investigations
    Blood creatine phosphokinase increased
         subjects affected / exposed
    2 / 39 (5.13%)
    1 / 78 (1.28%)
    1 / 81 (1.23%)
    0 / 42 (0.00%)
    3 / 80 (3.75%)
    4 / 37 (10.81%)
    3 / 74 (4.05%)
    2 / 79 (2.53%)
    2 / 114 (1.75%)
         occurrences all number
    2
    1
    1
    0
    3
    6
    3
    2
    3
    Injury, poisoning and procedural complications
    Vaccination complication
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    2 / 80 (2.50%)
    0 / 37 (0.00%)
    1 / 74 (1.35%)
    4 / 79 (5.06%)
    2 / 114 (1.75%)
         occurrences all number
    0
    0
    0
    0
    2
    0
    1
    4
    2
    Vascular disorders
    Hypertension
         subjects affected / exposed
    0 / 39 (0.00%)
    1 / 78 (1.28%)
    1 / 81 (1.23%)
    1 / 42 (2.38%)
    4 / 80 (5.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    1 / 79 (1.27%)
    2 / 114 (1.75%)
         occurrences all number
    0
    1
    1
    1
    5
    0
    0
    1
    2
    Nervous system disorders
    Headache
         subjects affected / exposed
    4 / 39 (10.26%)
    9 / 78 (11.54%)
    5 / 81 (6.17%)
    2 / 42 (4.76%)
    7 / 80 (8.75%)
    2 / 37 (5.41%)
    4 / 74 (5.41%)
    4 / 79 (5.06%)
    5 / 114 (4.39%)
         occurrences all number
    11
    28
    10
    7
    8
    6
    9
    6
    8
    General disorders and administration site conditions
    Injection site erythema
         subjects affected / exposed
    6 / 39 (15.38%)
    9 / 78 (11.54%)
    18 / 81 (22.22%)
    4 / 42 (9.52%)
    8 / 80 (10.00%)
    2 / 37 (5.41%)
    6 / 74 (8.11%)
    6 / 79 (7.59%)
    10 / 114 (8.77%)
         occurrences all number
    22
    42
    93
    12
    25
    32
    13
    36
    21
    Injection site reaction
         subjects affected / exposed
    5 / 39 (12.82%)
    16 / 78 (20.51%)
    18 / 81 (22.22%)
    9 / 42 (21.43%)
    16 / 80 (20.00%)
    3 / 37 (8.11%)
    12 / 74 (16.22%)
    14 / 79 (17.72%)
    14 / 114 (12.28%)
         occurrences all number
    19
    69
    75
    45
    84
    4
    40
    50
    101
    Injection site pain
         subjects affected / exposed
    3 / 39 (7.69%)
    4 / 78 (5.13%)
    10 / 81 (12.35%)
    5 / 42 (11.90%)
    7 / 80 (8.75%)
    4 / 37 (10.81%)
    6 / 74 (8.11%)
    6 / 79 (7.59%)
    9 / 114 (7.89%)
         occurrences all number
    6
    21
    45
    9
    39
    34
    7
    66
    45
    Injection site oedema
         subjects affected / exposed
    2 / 39 (5.13%)
    3 / 78 (3.85%)
    4 / 81 (4.94%)
    2 / 42 (4.76%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    3 / 74 (4.05%)
    3 / 79 (3.80%)
    3 / 114 (2.63%)
         occurrences all number
    2
    7
    4
    7
    0
    0
    12
    12
    8
    Injection site pruritus
         subjects affected / exposed
    2 / 39 (5.13%)
    3 / 78 (3.85%)
    1 / 81 (1.23%)
    1 / 42 (2.38%)
    4 / 80 (5.00%)
    1 / 37 (2.70%)
    1 / 74 (1.35%)
    3 / 79 (3.80%)
    0 / 114 (0.00%)
         occurrences all number
    2
    5
    6
    1
    5
    6
    1
    8
    0
    Injection site bruising
         subjects affected / exposed
    1 / 39 (2.56%)
    0 / 78 (0.00%)
    6 / 81 (7.41%)
    1 / 42 (2.38%)
    0 / 80 (0.00%)
    1 / 37 (2.70%)
    4 / 74 (5.41%)
    1 / 79 (1.27%)
    3 / 114 (2.63%)
         occurrences all number
    2
    0
    7
    2
    0
    4
    4
    4
    3
    Injection site swelling
         subjects affected / exposed
    1 / 39 (2.56%)
    2 / 78 (2.56%)
    7 / 81 (8.64%)
    5 / 42 (11.90%)
    10 / 80 (12.50%)
    4 / 37 (10.81%)
    0 / 74 (0.00%)
    2 / 79 (2.53%)
    4 / 114 (3.51%)
         occurrences all number
    5
    10
    12
    7
    25
    4
    0
    4
    27
    Pyrexia
         subjects affected / exposed
    1 / 39 (2.56%)
    1 / 78 (1.28%)
    3 / 81 (3.70%)
    2 / 42 (4.76%)
    5 / 80 (6.25%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    1 / 79 (1.27%)
    2 / 114 (1.75%)
         occurrences all number
    1
    1
    3
    2
    5
    0
    0
    1
    2
    Fatigue
         subjects affected / exposed
    0 / 39 (0.00%)
    4 / 78 (5.13%)
    2 / 81 (2.47%)
    1 / 42 (2.38%)
    5 / 80 (6.25%)
    1 / 37 (2.70%)
    1 / 74 (1.35%)
    1 / 79 (1.27%)
    2 / 114 (1.75%)
         occurrences all number
    0
    20
    2
    1
    5
    1
    1
    1
    2
    Injection site urticaria
         subjects affected / exposed
    0 / 39 (0.00%)
    2 / 78 (2.56%)
    6 / 81 (7.41%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    2 / 79 (2.53%)
    0 / 114 (0.00%)
         occurrences all number
    0
    4
    9
    0
    0
    0
    0
    5
    0
    Immune system disorders
    Food allergy
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    1 / 81 (1.23%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    2 / 37 (5.41%)
    0 / 74 (0.00%)
    1 / 79 (1.27%)
    2 / 114 (1.75%)
         occurrences all number
    0
    0
    1
    0
    0
    2
    0
    1
    2
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    3 / 39 (7.69%)
    7 / 78 (8.97%)
    4 / 81 (4.94%)
    1 / 42 (2.38%)
    5 / 80 (6.25%)
    2 / 37 (5.41%)
    1 / 74 (1.35%)
    2 / 79 (2.53%)
    4 / 114 (3.51%)
         occurrences all number
    4
    7
    4
    2
    5
    3
    1
    2
    4
    Abdominal pain
         subjects affected / exposed
    2 / 39 (5.13%)
    4 / 78 (5.13%)
    2 / 81 (2.47%)
    1 / 42 (2.38%)
    4 / 80 (5.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    2 / 79 (2.53%)
    4 / 114 (3.51%)
         occurrences all number
    3
    4
    2
    1
    4
    0
    0
    2
    4
    Diarrhoea
         subjects affected / exposed
    2 / 39 (5.13%)
    8 / 78 (10.26%)
    3 / 81 (3.70%)
    2 / 42 (4.76%)
    1 / 80 (1.25%)
    2 / 37 (5.41%)
    2 / 74 (2.70%)
    2 / 79 (2.53%)
    0 / 114 (0.00%)
         occurrences all number
    2
    12
    4
    2
    1
    2
    2
    2
    0
    Dysphagia
         subjects affected / exposed
    2 / 39 (5.13%)
    0 / 78 (0.00%)
    1 / 81 (1.23%)
    0 / 42 (0.00%)
    2 / 80 (2.50%)
    1 / 37 (2.70%)
    1 / 74 (1.35%)
    4 / 79 (5.06%)
    4 / 114 (3.51%)
         occurrences all number
    2
    0
    1
    0
    2
    1
    2
    4
    4
    Vomiting
         subjects affected / exposed
    1 / 39 (2.56%)
    4 / 78 (5.13%)
    3 / 81 (3.70%)
    2 / 42 (4.76%)
    3 / 80 (3.75%)
    1 / 37 (2.70%)
    3 / 74 (4.05%)
    2 / 79 (2.53%)
    4 / 114 (3.51%)
         occurrences all number
    1
    6
    5
    2
    3
    1
    4
    2
    4
    Dyspepsia
         subjects affected / exposed
    0 / 39 (0.00%)
    4 / 78 (5.13%)
    2 / 81 (2.47%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    4 / 74 (5.41%)
    2 / 79 (2.53%)
    4 / 114 (3.51%)
         occurrences all number
    0
    9
    2
    0
    0
    0
    6
    2
    6
    Eosinophilic oesophagitis
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    4 / 37 (10.81%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    0 / 114 (0.00%)
         occurrences all number
    0
    0
    0
    0
    0
    4
    0
    0
    0
    Respiratory, thoracic and mediastinal disorders
    Oropharyngeal pain
         subjects affected / exposed
    2 / 39 (5.13%)
    6 / 78 (7.69%)
    5 / 81 (6.17%)
    0 / 42 (0.00%)
    4 / 80 (5.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    2 / 79 (2.53%)
    1 / 114 (0.88%)
         occurrences all number
    2
    7
    6
    0
    4
    0
    0
    2
    1
    Rhinitis allergic
         subjects affected / exposed
    2 / 39 (5.13%)
    2 / 78 (2.56%)
    1 / 81 (1.23%)
    1 / 42 (2.38%)
    2 / 80 (2.50%)
    0 / 37 (0.00%)
    3 / 74 (4.05%)
    0 / 79 (0.00%)
    1 / 114 (0.88%)
         occurrences all number
    2
    2
    1
    1
    2
    0
    3
    0
    1
    Rhinorrhoea
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    3 / 42 (7.14%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    0 / 74 (0.00%)
    0 / 79 (0.00%)
    1 / 114 (0.88%)
         occurrences all number
    0
    0
    0
    3
    0
    0
    0
    0
    1
    Skin and subcutaneous tissue disorders
    Dermatitis atopic
         subjects affected / exposed
    4 / 39 (10.26%)
    1 / 78 (1.28%)
    0 / 81 (0.00%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    0 / 37 (0.00%)
    1 / 74 (1.35%)
    1 / 79 (1.27%)
    2 / 114 (1.75%)
         occurrences all number
    5
    1
    0
    0
    0
    0
    1
    1
    2
    Rash
         subjects affected / exposed
    4 / 39 (10.26%)
    0 / 78 (0.00%)
    4 / 81 (4.94%)
    0 / 42 (0.00%)
    3 / 80 (3.75%)
    1 / 37 (2.70%)
    0 / 74 (0.00%)
    2 / 79 (2.53%)
    7 / 114 (6.14%)
         occurrences all number
    4
    0
    4
    0
    3
    1
    0
    2
    9
    Acne
         subjects affected / exposed
    1 / 39 (2.56%)
    3 / 78 (3.85%)
    2 / 81 (2.47%)
    0 / 42 (0.00%)
    0 / 80 (0.00%)
    2 / 37 (5.41%)
    4 / 74 (5.41%)
    2 / 79 (2.53%)
    2 / 114 (1.75%)
         occurrences all number
    1
    3
    3
    0
    0
    2
    4
    2
    2
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    0 / 39 (0.00%)
    1 / 78 (1.28%)
    2 / 81 (2.47%)
    0 / 42 (0.00%)
    3 / 80 (3.75%)
    1 / 37 (2.70%)
    4 / 74 (5.41%)
    1 / 79 (1.27%)
    4 / 114 (3.51%)
         occurrences all number
    0
    1
    2
    0
    3
    1
    4
    1
    5
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    4 / 39 (10.26%)
    3 / 78 (3.85%)
    4 / 81 (4.94%)
    5 / 42 (11.90%)
    2 / 80 (2.50%)
    2 / 37 (5.41%)
    7 / 74 (9.46%)
    2 / 79 (2.53%)
    5 / 114 (4.39%)
         occurrences all number
    4
    4
    5
    6
    2
    2
    8
    3
    6
    Sinusitis
         subjects affected / exposed
    2 / 39 (5.13%)
    0 / 78 (0.00%)
    0 / 81 (0.00%)
    1 / 42 (2.38%)
    4 / 80 (5.00%)
    0 / 37 (0.00%)
    2 / 74 (2.70%)
    2 / 79 (2.53%)
    1 / 114 (0.88%)
         occurrences all number
    2
    0
    0
    1
    5
    0
    2
    2
    1
    COVID-19
         subjects affected / exposed
    1 / 39 (2.56%)
    0 / 78 (0.00%)
    5 / 81 (6.17%)
    0 / 42 (0.00%)
    4 / 80 (5.00%)
    1 / 37 (2.70%)
    7 / 74 (9.46%)
    8 / 79 (10.13%)
    10 / 114 (8.77%)
         occurrences all number
    1
    0
    5
    0
    4
    1
    7
    8
    10
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 39 (0.00%)
    2 / 78 (2.56%)
    2 / 81 (2.47%)
    4 / 42 (9.52%)
    3 / 80 (3.75%)
    0 / 37 (0.00%)
    2 / 74 (2.70%)
    0 / 79 (0.00%)
    6 / 114 (5.26%)
         occurrences all number
    0
    2
    2
    4
    4
    0
    2
    0
    7

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    04 Oct 2018
    Added an exclusion criterion: known systemic hypersensitivity to dupilumab or the excipients of the drug product; Exclusion Criterion # 26: replaced serum creatinine threshold with estimated glomerular filtration rate (eGFR); Exclusion Criterion #27: replaced the example for severe renal conditions of “patients on dialysis” with “severe nephrotic syndrome”; Exclusion Criterion #33: Added clarification that the reliability of sexual abstinence needs to be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient based on Clinical Trial Facilitation Group guideline on contraception; Clarified criteria for resumption of treatment after study drug has been temporarily discontinued because of a severe laboratory abnormality.
    18 Apr 2019
    Per Health Authority request, changed Part C from open-label to a design with added placebo SC injections alternating with dupilumab 300 mg Q2W doses in order to mask the dosing regimen for Part B patients during this extended active treatment phase of the study; Added a per protocol set to the defined efficacy analysis sets to assess the overall robustness of the analysis results. Added that any re-estimation of sample size for Part B will be documented in the Part B SAP before its database lock. If the re-estimated sample size requires an increase of the planned sample size in Part B by more than 86 total patients (25%), it will also be documented in a protocol amendment so as to inform Has, ECs, and investigators; Added a substudy which may be performed at select sites and a secondary endpoint to the study for the endolumenal functional lumen imaging probe (EndoFLIP) procedure to measure esophageal distensibility during the esophagogastroscopy procedures at selected sites in approximately 150 adult patients; Added additional secondary endpoints for proportion of patients who receive rescue medications or procedures during the 24-week placebo-controlled treatment period and absolute change in EoE Stage Score from the EoEHSS from baseline to week 24.
    10 Mar 2020
    The purpose of this amendment was to add transcriptome sequencing for analyzing RNA expression of eosinophilic esophagitis (EoE) and type 2 inflammation to the study secondary objectives and endpoints, and to add the European Quality of Life 5-dimension 3-level (EQ-5D3L) Questionnaire to collect general health status of EoE patients. Additionally, the Eosinophilic Esophagitis-Endoscopic Reference Score (EoE-EREFS) procedure for Part B patients was revised to allow for centralized reading and scoring. Other minor changes were made to align with regulatory authority feedback and for general clarification.
    16 Apr 2020
    The purpose of this protocol amendment was to protect patient safety and data integrity during the COVID-19 pandemic by allowing for certain study procedures to occur at delayed time points and/or outside of the clinic environment. All temporary mechanisms utilized, and deviations from planned study procedures are to be documented as being related to COVID-19 and will remain in effect only for the duration of the public health emergency.
    05 Nov 2020
    The purpose of this protocol amendment was to adjust the sample size for Part B based on the results of Part A of the study, and to add an additional database lock after all patients in Part A complete study week 52 of Part C. Other changes were made for clarification and consistency

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    27 Mar 2020
    Enrollment was halted due to operational challenges associated with measures in place to limit the spread of the COVID-19 pandemic.
    01 Jun 2020

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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