Dupilumab Improves Oesophageal Remodelling in Eosinophilic Oesophagitis: AMJ | October 2026

What Did the Study Find?

The REMODEL trial randomised 69 adults with Eosinophilic oesophagitis to weekly subcutaneous Dupilumab 300 mg (46 patients) or placebo (23 patients). The primary endpoint was change in oesophageal distensibility plateau diameter measured using the functional lumen imaging probe (FLIP).

At week 24, distensibility increased by 1.28 mm with dupilumab versus a decrease of 0.01 mm with placebo, producing a between-group difference of 1.30 mm (95% CI 0.31–2.29). Among patients with reduced baseline distensibility, the difference was larger at 2.21 mm. Dupilumab also improved endoscopic findings and histological grade and stage scores. No new safety signals were identified.

Why Does It Matter?

EoE can cause progressive oesophageal remodelling, narrowing and food impaction. These findings suggest that biologic therapy can improve not only inflammatory activity but also an important measure of oesophageal mechanical function. However, the trial was small, and improved FLIP measurements do not establish a reduction in food impactions, dilations or long-term stricture formation.

GastroAGI Takeaway: Dupilumab may improve both inflammation and oesophageal distensibility in EoE, but larger studies must establish whether these structural improvements translate into fewer clinical complications.