Resources not available to continue study

This is a phase 2, multicenter, randomized, double-blind, parallel group, 2 arm study in approximately 40 subjects aged 4 to 50 years, inclusive, who are allergic to cow's milk. The primary objective is to assess whether dupilumab as an adjunct to milk oral immunotherapy (OIT) compared to placebo improves the safety of milk OIT and rates of desensitization, defined as an increase in the proportion of subjects who pass a double-blind placebo-controlled food challenge (DBPCFC) to at least 2040 mg cumulative milk protein at week 18.

Inclusion Criteria:

• Age 4 to 50 years (inclusive)
• Clinical history of allergy to cow's milk or milk-containing foods
• Serum IgE to milk of >4 kUA/L within the last 12 months and/or a SPT to milk ≥6 mm compared to a negative control
• Experience clinical reaction at or before 444 mg cumulative protein dose of cow's milk protein on Screening DBPCFC
• No clinical reaction observed during the placebo (oat) Screening DBPCFC
• Subjects with other known food allergies must agree to eliminate these other food items from their diet so as not to confound the safety and efficacy data from the study
• Use of effective birth control by female participants of childbearing potential

Exclusion Criteria:

• Any previous exposure to dupilumab
• Known hypersensitivity to dupilumab or any of its excipients
• Known hypersensitivity to epinephrine or any of its excipients
• Allergy to oat (placebo in DBPCFC)
• History of severe anaphylaxis to cow's milk, defined as neurological compromise or requiring intubation
• Recent history of frequent severe, life-threatening episodes of anaphylaxis or anaphylactic shock as defined as 3 or more episodes of anaphylaxis within the past year
• Inability to tolerate biological (antibody) therapies
• Body weight <5 kg at the time of screening
• History of eosinophilic esophagitis (EoE), other eosinophilic gastrointestinal disease, chronic, recurrent, or severe gastroesophageal reflux disease (GERD), symptoms of dysphagia (e.g., difficulty swallowing, food "getting stuck"), or recurrent gastrointestinal symptoms of undiagnosed etiology
• History of cardiovascular disease, including uncontrolled or inadequately controlled hypertension
• History of a mast cell disorder
• Established diagnosis of a primary immunodeficiency disorder
• Severe asthma or mild or moderate asthma if uncontrolled or difficult to control
• Current participation or within the last 4 months in any other interventional study
• Use of medication such as beta-blockers (oral), angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blockers (ARB) or calcium channel blockers
• Pregnant or breastfeeding women

From enrollment until end of follow-up, up to 24 weeks

Study findings are limited by the small sample size and high attrition. Screen failures and early loss to follow-up reduced power and may limit the ability to draw definitive conclusions about the intervention's effect.