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| Name | Class |
|---|---|
| Regeneron Pharmaceuticals | INDUSTRY |
| Genzyme, a Sanofi Company | INDUSTRY |
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Eosinophilic Esophagitis (EoE) is a food driven non-immunoglobulin E (IgE) mediated disease involving eosinophils and type 2 inflammation. Current therapies include diet and the off label use of medications including proton pump inhibitors, topical steroids or biologics. Food elimination creates a decrease quality of life in many children. The goal of the study is to examine a T2 inhibitor (dupilumab) can allow successful reintroduction of allergic EoE foods into the diet. This is a single site study, enrolling subjects 6 to 25 years of age.
This study is an open label exploratory study to examine if patients controlled with dupilumab can successful introduce EoE trigger foods back into their diet.
This is a single site study, enrolling subjects 6 to 25 years of age. In the initial 12 week period, patients will be start on dupilumab on the doses used in the phase 3 trials to control disease. If disease is controlled based on histologic and symptom control at week 12 endoscopy, patients will be start on EoE trigger food. The trigger foods will be based on both a combination of history and histology results. The food will have trigger EoE by histology in the last 2 years and symptoms in the last year when reintroduced into the diet. The study will focus on the the four most common foods that trigger EoE: milk, egg, wheat and soy. For the initial food introduction, the subjects will add one serving size of the food daily for 12 weeks. After 12 weeks, the subjects will have a 2nd endoscopy if the 2nd endoscopy is normal, the subjects will increase the trigger food to 2 serving sizes a day or add an additional trigger food. A 3rd endoscopy will be done if the patients increases the food amount or adds a new food at week 36 (12 weeks after adding the new food). If the subject does not increase or add new foods at week 24, the 3rd endoscopy will not be obtained. All subjects will have end of study endoscopy at week 48.
If the subjects have abnormal endoscopy or increase in symptoms, the amount food will be reduced by 50% and repeat endoscopy will be obtained at the same time schedule-12 weeks later.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study Group | Experimental | 30 patients will be given dupilumab (dose based on current approved doses or used in current EoE clinical trial, q weekly dosing) and monitored for clinical response after 12 weeks of therapy) Dosing: >12 years of age > 40 kg 300 SQ weekly 30- 40 kg 300 mg SQ Q2 weeks 15-29.9 kg 200 mg SQ Q2 weeks 6-11 years of age 5-15 kg 100 mg SQ Q2W 15-30 kg 200 mg SQ Q2W >30-60 kg 300 mg SQ Q2W |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Eosinophilic Esophagitis (EoE) food introduction-1st | Dietary Supplement | 1 serving size of food proven to induce histologic and clinical symptoms in EoE |
|
| Measure | Description | Time Frame |
|---|---|---|
| Esophageal Eosinophilia (Number of Eosinophils in the Esophagus) | Eosinophils per high power field on esophageal biopsy | week 24 |
| Esophageal Eosinophilia (Number of Eosinophils in the Esophagus) | Eosinophils per high power field on esophageal biopsy | week 48 |
| Esophageal Eosinophilia (Number of Eosinophils in the Esophagus) | Eosinophils per high power field on esophageal biopsy | week 36 |
| Measure | Description | Time Frame |
|---|---|---|
| Pediatric Eosinophilic Esophagitis Symptom Score (Total Score Based on Pediatric Symptom Score) | Min 0-Max-100, lower is better | week 24 |
| Pediatric Eosinophilic Esophagitis Symptom Score (Total Score Based on Pediatric Symptom Score) |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of Maintenance of Remission (Less Than <6 Eos/Hpf) in Esophageal Biopsy | Less than 6 eosinophils per high power field in peak count in esophageal biopsy | week 24 |
| Rate of Maintenance of Remission (Less Than <6 Eos/Hpf) in Esophageal Biopsy |
Inclusion Criteria:
Males or females age 6 to 25 years
Diagnosis of Eosinophilic Esophagitis based on the most recent international consensus definition (Dellon et al, Gastroenterology 2019)
a) History of endoscopy with a peak count of >15 eosinophils per high powered field meeting consensus criteria for Eosinophilic Esophagitis1
History of either milk, egg, soy or wheat induced EoE based on the following criteria in the last two years
Weight > 10 kg
Ability to remain on stable dose of Proton Pump Inhibitor (PPI) therapy throughout the study
Girls > 11 years of age must have a negative urine/serum pregnancy test.
Parental/guardian permission (informed consent) and if appropriate, child assent.
Exclusion Criteria:
Tracheo-esophageal fistulas, inflammatory bowel disease, Barrett's disease, or other significant inflammatory disease of the gastrointestinal tract
Biopsy evidence of eosinophilic infiltration in any other organ system
History of significant esophageal procedures e.g. sclerotherapy or esophagectomy
Systemic immunosuppressant usage in prior 3 months
Narrow caliber esophagus defined as the inability to pass a 9.5 mm endoscopy into the esophagus
IgE mediated reaction to food (milk, egg, soy or wheat) being introduced in the last 12 months
Therapy with biologic molecule (e.g. omalizumab, infliximab) in prior 12 months
Any factors that may pose a significant risk for undergoing anesthesia/sedation
Subjects undergoing any type of immunotherapy to any food (oral immunotherapy, sublingual immunotherapy, specific oral tolerance induction) within 3 months prior to Visit 1.
Active IgE- mediated milk, egg, wheat or soy allergy based on skin test or history (if those foods are being introduced back into the diet).
Allergy or known hypersensitivity to the dupilumab.
Subjects (or parents of subjects) with obvious excessive anxiety and unlikely to cope with the conditions of an upper Endoscopy and biopsy.
Past or current disease(s), which in the opinion of the Investigator or the Sponsor, may affect the subject's participation in this study, including but not limited to active autoimmune disorders, immunodeficiency, malignancy, uncontrolled diseases (hypertension, psychiatric (especially anxiety), cardiac), or other disorders (e.g., liver, gastrointestinal, kidney, cardiovascular, pulmonary disease, or blood disorders).
Participation in another clinical intervention study in the three months prior to Visit 1.
Subjects unable to follow the protocol and the protocol requirements.
Subjects on any experimental drugs or treatments.
Subjects unable to read/understand English or follow the protocol and the protocol requirements.
Subjects unable to read/understand English or follow the protocol and the protocol requirements.
Treatment with a live (attenuated) vaccine within 4 weeks before the baseline visit or throughout the trial
Major elective surgeries are prohibited during the study
Female patients who are pregnant, breastfeeding, or planning to become pregnant or breastfeed during the study
Women of children bearing potential (WOCBP) who are unwilling to practice highly effective contraception prior to the initial dose/start of the first treatment, during the study, and for at least 12 weeks after the last dose. This includes female patients who experience menarche during the study duration and who are unwilling to follow the precautions for WOCBP.
Chronic or acute infection requiring treatment with systemic antibiotic, antivirals, or antifungal within 2 weeks of baseline visits
a. Patients maybe rescreened after infection resolves
Participants with active or suspected parasitic infection are excluded.
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| Name | Affiliation | Role |
|---|---|---|
| Jonathan Spergel, MD, PhD | Children's Hospital of Philadelphia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Children's Hospital of Philadelphia | Philadelphia | Pennsylvania | 19104 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37660704 | Background | Rothenberg ME, Dellon ES, Collins MH, Hirano I, Chehade M, Bredenoord AJ, Lucendo AJ, Spergel JM, Sun X, Hamilton JD, Mortensen E, Laws E, Maloney J, Mannent LP, McCann E, Liu X, Glotfelty L, Shabbir A. Efficacy and safety of dupilumab up to 52 weeks in adults and adolescents with eosinophilic oesophagitis (LIBERTY EoE TREET study): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Gastroenterol Hepatol. 2023 Nov;8(11):990-1004. doi: 10.1016/S2468-1253(23)00204-2. Epub 2023 Aug 31. | |
| 38010430 |
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After the study is completed and published, we will share the study protocol and limited deidentified data.
The data will be released after the data is published.
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Open label study, all assigned dupilumab
21 patients recruited
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| ID | Title | Description |
|---|---|---|
| FG000 | Study Group | 30 patients will be given dupilumab (dose based on current approved doses or used in current EoE clinical trial, q weekly dosing) and monitored for clinical response after 12 weeks of therapy) Dosing: >12 years of age > 40 kg 300 SQ weekly 30- 40 kg 300 mg SQ Q2 weeks 15-29.9 kg 200 mg SQ Q2 weeks 6-11 years of age 5-15 kg 100 mg SQ Q2W 15-30 kg 200 mg SQ Q2W >30-60 kg 300 mg SQ Q2W |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Dec 29, 2022 |
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All patients receive active therapy
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| Eosinophilic Esophagitis (E0E) food introduction-2nd | Dietary Supplement | Either 1 serving size of different food (not food in arm 1) to induce histologic and clinical symptoms in EoE or Increase the food in arm 1 to 2 serving size a day |
|
| Eosinophilic Esophagitis (EoE) Food introduction-3rd dose | Dietary Supplement | Either 1 serving size of different food (not food in arm 1 or 2) to induce histologic and clinical symptoms in EoE or Increase the food in arm 2 to 2 serving size a day or unlimited amounts of food arm 1 |
|
| Dupilumab | Drug | All patients will receive open label dupilumab at the following doses >12 years of age > 40 kg 300 subcutaneous (SQ) weekly 6-11 years of age 5-15 kg 100 mg SQ every 2 weeks (Q2W) 15-30 kg 200 mg SQ Q2W >30-60 kg 300 mg SQ Q2W |
|
Min 0-Max-100, lower is better
| week 36 |
| Pediatric Eosinophilic Esophagitis Symptom Score (Total Score Based on Pediatric Symptom Score) | Min 0-Max-100, lower is better | week 48 |
Less than 6 eosinophils per high power field in peak count in esophageal biopsy
| week 36 |
| Rate of Maintenance of Remission (Less Than <6 Eos/Hpf) in Esophageal Biopsy | Less than 6 eosinophils per high power field in peak count in esophageal biopsy | week 48 |
| Rate of Maintenance of Remission (Less Than <15 Eos/Hpf) in Esophageal Biopsy | Less than 15 eosinophils per high power field in peak count in esophageal biopsy | Week 24 |
| Rate of Maintenance of Remission (Less Than <15 Eos/Hpf) in Esophageal Biopsy | Less than 15 eosinophils per high power field in peak count in esophageal biopsy | Week 36 |
| Rate of Maintenance of Remission (Less Than <15 Eos/Hpf) in Esophageal Biopsy | Less than15 eosinophils per high power field in peak count in esophageal biopsy | Week 48 |
| Change in Endoscopic Scoring System (EREFS) | Changes from baseline from upper endoscopy validated score (0-10), lower is better | week 24 |
| Change in Endoscopic Scoring System (EREFS) | Changes from baseline from upper endoscopy validated score (0-10), lower is better | week 36 |
| Change in Endoscopic Scoring System (EREFS) | Changes from baseline from upper endoscopy validated score (0-10), lower is better | week 48 |
| Changes in EoE Quality of Life From Baseline | Changes from baseline in EoE specific Health related Quality of Life (range 0-96), higher is worse | week 24 |
| Changes in EoE Quality of Life From Baseline | Changes from baseline in EoE Health related Quality of Life (range 0-96), higher is worse | week 36 |
| Changes in EoE Quality of Life From Baseline | Changes from baseline in EoE Health related Quality of Life (range 0-96), higher is worse | week 48 |
| Background |
| McCann E, Chehade M, Spergel JM, Yaworsky A, Symonds T, Stokes J, Tilton ST, Sun X, Kamat S. Validation of the novel Eosinophilic Esophagitis Impact Questionnaire. J Patient Rep Outcomes. 2023 Nov 27;7(1):120. doi: 10.1186/s41687-023-00654-z. |
| 36546624 | Background | Dellon ES, Rothenberg ME, Collins MH, Hirano I, Chehade M, Bredenoord AJ, Lucendo AJ, Spergel JM, Aceves S, Sun X, Kosloski MP, Kamal MA, Hamilton JD, Beazley B, McCann E, Patel K, Mannent LP, Laws E, Akinlade B, Amin N, Lim WK, Wipperman MF, Ruddy M, Patel N, Weinreich DR, Yancopoulos GD, Shumel B, Maloney J, Giannelou A, Shabbir A. Dupilumab in Adults and Adolescents with Eosinophilic Esophagitis. N Engl J Med. 2022 Dec 22;387(25):2317-2330. doi: 10.1056/NEJMoa2205982. |
| 35085819 | Background | Spergel BL, Ruffner MA, Godwin BC, Liacouras CA, Cianferoni A, Gober L, Hill DA, Brown-Whitehorn TF, Chaiboonma K, Aceves SA, Muir AM, Spergel JM. Improvement in eosinophilic esophagitis when using dupilumab for other indications or compassionate use. Ann Allergy Asthma Immunol. 2022 May;128(5):589-593. doi: 10.1016/j.anai.2022.01.019. Epub 2022 Jan 25. |
| 30009819 | Background | Dellon ES, Liacouras CA, Molina-Infante J, Furuta GT, Spergel JM, Zevit N, Spechler SJ, Attwood SE, Straumann A, Aceves SS, Alexander JA, Atkins D, Arva NC, Blanchard C, Bonis PA, Book WM, Capocelli KE, Chehade M, Cheng E, Collins MH, Davis CM, Dias JA, Di Lorenzo C, Dohil R, Dupont C, Falk GW, Ferreira CT, Fox A, Gonsalves NP, Gupta SK, Katzka DA, Kinoshita Y, Menard-Katcher C, Kodroff E, Metz DC, Miehlke S, Muir AB, Mukkada VA, Murch S, Nurko S, Ohtsuka Y, Orel R, Papadopoulou A, Peterson KA, Philpott H, Putnam PE, Richter JE, Rosen R, Rothenberg ME, Schoepfer A, Scott MM, Shah N, Sheikh J, Souza RF, Strobel MJ, Talley NJ, Vaezi MF, Vandenplas Y, Vieira MC, Walker MM, Wechsler JB, Wershil BK, Wen T, Yang GY, Hirano I, Bredenoord AJ. Updated International Consensus Diagnostic Criteria for Eosinophilic Esophagitis: Proceedings of the AGREE Conference. Gastroenterology. 2018 Oct;155(4):1022-1033.e10. doi: 10.1053/j.gastro.2018.07.009. Epub 2018 Sep 6. |
| 41038415 | Derived | Wolfset N, Muir AB, Benitez AJ, Williams D, De La Torre I, Ruffner MA, Hill DA, Cazeau C, Angello JT, Radwan A, Durrani S, deMarchi S, Spergel JM. Efficacy of Dupilumab on Facilitated Food Reintroduction in Eosinophilic Esophagitis. Clin Gastroenterol Hepatol. 2026 May;24(5):1271-1279. doi: 10.1016/j.cgh.2025.08.025. Epub 2025 Sep 30. |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Study Group | 30 patients will be given dupilumab (dose based on current approved doses or used in current EoE clinical trial, q weekly dosing) and monitored for clinical response after 12 weeks of therapy) Dosing: >12 years of age > 40 kg 300 SQ weekly 30- 40 kg 300 mg SQ Q2 weeks 15-29.9 kg 200 mg SQ Q2 weeks 6-11 years of age 5-15 kg 100 mg SQ Q2W 15-30 kg 200 mg SQ Q2W >30-60 kg 300 mg SQ Q2W |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Atopy | Atopic History | Number | Count of Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Esophageal Eosinophilia (Number of Eosinophils in the Esophagus) | Eosinophils per high power field on esophageal biopsy | 5 patients dropped out to subject withrdraw and anxiety due to injections before completing this endpoint | Posted | Mean | Standard Deviation | eosinophils/high power field | week 24 |
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| Primary | Esophageal Eosinophilia (Number of Eosinophils in the Esophagus) | Eosinophils per high power field on esophageal biopsy | 2 patients dropped before this time point | Posted | Mean | Standard Deviation | eosinophils per high power field | week 48 |
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| ||||||||||||||||||||||||||
| Primary | Esophageal Eosinophilia (Number of Eosinophils in the Esophagus) | Eosinophils per high power field on esophageal biopsy | Posted | Mean | Standard Deviation | eosinophils/high power field | week 36 |
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| Secondary | Pediatric Eosinophilic Esophagitis Symptom Score (Total Score Based on Pediatric Symptom Score) | Min 0-Max-100, lower is better | Posted | Mean | Standard Deviation | units on a scale | week 24 |
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| Secondary | Pediatric Eosinophilic Esophagitis Symptom Score (Total Score Based on Pediatric Symptom Score) | Min 0-Max-100, lower is better | Posted | Mean | Standard Deviation | units on a scale | week 36 |
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| Secondary | Pediatric Eosinophilic Esophagitis Symptom Score (Total Score Based on Pediatric Symptom Score) | Min 0-Max-100, lower is better | Posted | Mean | Standard Deviation | units on a scale | week 48 |
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| Other Pre-specified | Rate of Maintenance of Remission (Less Than <6 Eos/Hpf) in Esophageal Biopsy | Less than 6 eosinophils per high power field in peak count in esophageal biopsy | Posted | Count of Participants | Participants | week 24 |
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| Other Pre-specified | Rate of Maintenance of Remission (Less Than <6 Eos/Hpf) in Esophageal Biopsy | Less than 6 eosinophils per high power field in peak count in esophageal biopsy | Posted | Count of Participants | Participants | week 36 |
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| Other Pre-specified | Rate of Maintenance of Remission (Less Than <6 Eos/Hpf) in Esophageal Biopsy | Less than 6 eosinophils per high power field in peak count in esophageal biopsy | Posted | Count of Participants | Participants | week 48 |
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| Other Pre-specified | Rate of Maintenance of Remission (Less Than <15 Eos/Hpf) in Esophageal Biopsy | Less than 15 eosinophils per high power field in peak count in esophageal biopsy | Posted | Count of Participants | Participants | Week 24 |
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| Other Pre-specified | Rate of Maintenance of Remission (Less Than <15 Eos/Hpf) in Esophageal Biopsy | Less than 15 eosinophils per high power field in peak count in esophageal biopsy | Posted | Count of Participants | Participants | Week 36 |
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| Other Pre-specified | Rate of Maintenance of Remission (Less Than <15 Eos/Hpf) in Esophageal Biopsy | Less than15 eosinophils per high power field in peak count in esophageal biopsy | Posted | Count of Participants | Participants | Week 48 |
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| Other Pre-specified | Change in Endoscopic Scoring System (EREFS) | Changes from baseline from upper endoscopy validated score (0-10), lower is better | Posted | Mean | Standard Deviation | units on a scale | week 24 |
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| Other Pre-specified | Change in Endoscopic Scoring System (EREFS) | Changes from baseline from upper endoscopy validated score (0-10), lower is better | Posted | Mean | Standard Deviation | units on a scale | week 36 |
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| Other Pre-specified | Change in Endoscopic Scoring System (EREFS) | Changes from baseline from upper endoscopy validated score (0-10), lower is better | Posted | Mean | Standard Deviation | units on a scale | week 48 |
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| Other Pre-specified | Changes in EoE Quality of Life From Baseline | Changes from baseline in EoE specific Health related Quality of Life (range 0-96), higher is worse | Posted | Mean | Standard Deviation | units on a scale | week 24 |
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| Other Pre-specified | Changes in EoE Quality of Life From Baseline | Changes from baseline in EoE Health related Quality of Life (range 0-96), higher is worse | Posted | Mean | Standard Deviation | units on a scale | week 36 |
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| Other Pre-specified | Changes in EoE Quality of Life From Baseline | Changes from baseline in EoE Health related Quality of Life (range 0-96), higher is worse | Posted | Mean | Standard Deviation | units on a scale | week 48 |
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Enrollment until end of follow-up (up to 52 weeks)
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Study Group | 30 patients will be given dupilumab (dose based on current approved doses or used in current EoE clinical trial, q weekly dosing) and monitored for clinical response after 12 weeks of therapy) Dosing: >12 years of age > 40 kg 300 SQ weekly 30- 40 kg 300 mg SQ Q2 weeks 15-29.9 kg 200 mg SQ Q2 weeks 6-11 years of age 5-15 kg 100 mg SQ Q2W 15-30 kg 200 mg SQ Q2W >30-60 kg 300 mg SQ Q2W | 0 | 21 | 1 | 21 | 10 | 21 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Depression | Psychiatric disorders | MedRA | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| headache | Nervous system disorders | MedRA | Systematic Assessment |
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| Upper respiratory infection | Infections and infestations | MedRA | Systematic Assessment |
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| abdominal Pain | Gastrointestinal disorders | MedRA | Systematic Assessment |
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| Injection Reaction | Skin and subcutaneous tissue disorders | MedRA | Systematic Assessment |
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| nausea | Gastrointestinal disorders | MedRA | Systematic Assessment |
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| diarrhea | Gastrointestinal disorders | MedRA | Systematic Assessment |
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| Congestion | Respiratory, thoracic and mediastinal disorders | MedRA | Systematic Assessment |
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The study was only completed in pediatrics. If is unclear if the results will extend to adults.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Jonathan Spergel | Children's Hospital of Philadelphia | 2155902549 | spergel@chop.edu |
| Aug 21, 2025 |
| Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Oct 24, 2023 | Aug 28, 2025 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D057765 | Eosinophilic Esophagitis |
| ID | Term |
|---|---|
| D004941 | Esophagitis |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D005759 | Gastroenteritis |
| D004802 | Eosinophilia |
| D007960 | Leukocyte Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| C582203 | dupilumab |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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