Dupilumab Shows Efficacy in Eosinophilic Esophagitis Regardless of Food Elimination Diets
The impact of food elimination diets on medication previously was unknown, according to new research presented at AAAAI 2025.
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A post hoc analysis of the LIBERTY EoE TREET clinical trial presented at the 2025 American Academy of Allergy, Asthma & Immunology (AAAAI) and World Allergy Organization (WAO) Joint Congress suggests that dupilumab improves histologic, symptomatic, and endoscopic outcomes in adolescents and adults with eosinophilic esophagitis (EoE), regardless of concurrent food elimination diet (FED) use.
Researchers analyzed data from LIBERTY EoE TREET (NCT03633617), a phase 3 study evaluating weekly 300 mg dupilumab injections in patients with EoE. Participants either continued or did not follow a FED throughout the study period.
At Week 24, the proportion of patients achieving ≤6 eosinophils per high-power field was comparable between those on a FED (61.3% for dupilumab vs 3.4% for placebo) and those not on a FED (57.1% vs 8.0%). Similar trends were observed in Dysphagia Symptom Questionnaire (DSQ) scores, Endoscopic Reference Score (EREFS), and EoE Histologic Scoring System (EoE-HSS) assessments.
At week 52, patients who continued dupilumab treatment maintained improvements, and those who switched from placebo to dupilumab showed comparable benefits, independent of FED status.
EoE is a chronic, progressive, non-IgE-mediated inflammatory disease often managed with elimination diets, which require significant dietary restrictions. The study suggests that dupilumab provides clinical benefits regardless of dietary modifications, potentially reducing the burden on patients adhering to strict FED protocols.
“Dupilumab demonstrated consistent efficacy across key disease measures, independent of concurrent FED use,” researchers concluded.
Dupilumab is currently approved for EoE treatment, but the findings may help guide treatment decisions for clinicians managing patients who struggle with dietary adherence.
Reference: Cianferoni A, et al. Poster 453. Presented at: 2025 AAAAI/WAO Joint Congress; Feb. 23-March 3, 2025; San Diego.
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