S890 Sustained Treatment Response With Dupilumab in Dysphagia and Odynophagia in Adults and Adolescents With Eosinophilic Esophagitis: Post-Hoc Analysis of the LIBERTY EoE TREET Study up to 52 Weeks

Introduction: The daily lives of patients with eosinophilic esophagitis (EoE), a type 2 inflammatory disease of the esophagus, may be disrupted by dysphagia and odynophagia. Dupilumab, a fully human monoclonal antibody that blocks the signaling of key drivers of type 2 inflammation, is approved in the U.S. and E.U. for EoE in patients aged ≥1 year weighing ≥15 kg. In the pivotal phase 3 LIBERTY EoE TREET study (NCT03633617), dupilumab 300 mg weekly significantly improved dysphagia vs placebo at week 24. Here, we further assessed the impact of continued dupilumab use on dysphagia and odynophagia. Methods: Data were pooled from patients aged ≥12 years, treated with dupilumab weekly or placebo for 24 weeks in Parts A and B of LIBERTY EoE TREET who continued to Part C and received dupilumab weekly to week 52. The number of days without dysphagia (Dysphagia Symptom Questionnaire [DSQ] question [Q] 2) and number of days without odynophagia (DSQ Q4; answered only if dysphagia is reported in Q2) over a 14-day period were analyzed at baseline and every 2 weeks to week 52. The proportion of patients with 0 days of dysphagia or 0 days of odynophagia over each 14-day period was also analyzed. Odynophagia outcomes were in patients with ≥1 day of odynophagia in the 14 days prior to baseline. Results: At baseline, all patients reported dysphagia; 108/114 (95%) and 65/74 (88%) patients who received dupilumab and placebo, respectively, reported odynophagia. At week 24, the mean (95% confidence interval [CI]) number of days without dysphagia was greater in patients on dupilumab vs placebo (8.7 [7.8, 9.5] vs 5.5 [4.2, 6.7], respectively; P < 0.0001). The mean (95% CI) number of days without odynophagia was also greater in patients on dupilumab vs placebo (10.1 [9.3, 10.8] vs 6.8 [5.5, 8.1], respectively; P < 0.0001) at week 24. At week 52, the mean number of days without dysphagia and without odynophagia increased in patients switching from placebo to dupilumab (dysphagia 8.6 [7.2, 10.0] and odynophagia 8.9 [7.4, 10.4]) and was maintained in patients continuing dupilumab (9.4 [8.4, 10.4] and 10.6 [9.9, 11.4]). At week 24, larger proportions of dupilumab-treated patients had 0 days of dysphagia and 0 days of odynophagia over a 14-day period. Conclusion: Dupilumab improved the number of days without dysphagia and without odynophagia vs placebo at week 24, with improvements maintained to week 52. Similar improvements were seen in the proportion of patients with resolution of dysphagia or odynophagia.