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News
A new trial shows dupilumab doesn't just calm inflammation in eosinophilic esophagitis — it physically widens the esophagus. In the phase 4 REMODEL trial, adults treated with dupilumab saw a meaningful increase in esophageal diameter over 24 weeks compared to placebo, without any dilation procedures. The findings suggest the drug may tackle both the inflammatory and structural complications of EoE.
Dupilumab, already approved for eosinophilic esophagitis (EoE), may do more than reduce inflammation — it appears to physically remodel the esophagus. In the phase 4 REMODEL trial, 69 adults with EoE were randomized 2:1 to receive dupilumab 300 mg weekly or placebo for 24 weeks. Those on dupilumab showed a significantly greater improvement in esophageal distensibility (a measure of how wide and flexible the esophagus is) compared to placebo.
What makes this especially notable: esophageal dilation procedures were not allowed during the study, yet the diameter gains seen with dupilumab were comparable to what a dilation session would typically achieve. Improvements in endoscopic severity scores were also significantly greater with dupilumab, including in fibrostenotic features — the scarring and narrowing that often require invasive treatment.
Key Takeaways:
Why it matters: EoE-related esophageal narrowing often requires repeated dilation procedures. These findings suggest dupilumab may reduce or eliminate that need by addressing both the inflammatory and structural dimensions of the disease — a meaningful shift in how EoE could be managed long-term.
