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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05831176
Registration number
NCT05831176
Ethics application status
Date submitted
14/04/2023
Date registered
26/04/2023
Titles & IDs
Public title
A Trial to Learn if Dupilumab is Safe for and Helps Adult and Adolescent Participants With Eosinophilic Gastritis With or Without Eosinophilic Duodenitis
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Scientific title
A Phase 2/3, Randomized, 3-Part Study to Investigate the Efficacy and Safety of Dupilumab in Adult and Adolescent Patients With Eosinophilic Gastritis With or Without Eosinophilic Duodenitis
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Secondary ID [1]
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2022-500795-62-00
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Secondary ID [2]
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R668-EGE-2213
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Universal Trial Number (UTN)
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Trial acronym
ENGAGE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Eosinophilic Gastritis
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Eosinophilic Duodenitis
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Eosinophilic Gastrointestinal Disease
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Condition category
Condition code
Oral and Gastrointestinal
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0
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Inflammatory and Immune System
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0
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0
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Allergies
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Inflammatory and Immune System
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0
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Other inflammatory or immune system disorders
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Blood
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Other blood disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Dupilumab Dose 1
Treatment: Drugs - Dupilumab Dose 2
Treatment: Drugs - Matching Placebo
Experimental: Part A: Phase 2 - Randomized 1:1
Experimental: Part B: Phase 3 - Randomized 1:1:1
Experimental: Part C: Extended Active Treatment Period - Eligible participants from Part A and Part B will enter Part C. Part A participants will get Dose 1. Part B participants who received Dose 1 or Dose 2 will remain on Dose 1 or Dose 2. Part B placebo participants will be randomized 1:1 to receive Dose 1 or Dose 2.
Treatment: Drugs: Dupilumab Dose 1
Administered subcutaneously (SC) once weekly (QW)
Treatment: Drugs: Dupilumab Dose 2
Administered SC once every 2 weeks (Q2W)
Treatment: Drugs: Matching Placebo
Administered SC
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Proportion of participants achieving a peak gastric eosinophil count of =6 eosinophils/high power field (eos/hpf)
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Assessment method [1]
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Part A and Part B
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Timepoint [1]
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At Week 24
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Primary outcome [2]
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Absolute change in the Eosinophilic Gastritis/Eosinophilic Duodenitis Symptom Questionnaire (EoG/EoD-SQ) Total Symptom Score (TSS)
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Assessment method [2]
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Part B Only
EoG/EoD-SQ is a patient reported outcome (PRO) collected daily via an eDiary. Symptoms are assessed using an 11-point numerical rating scale (0 through 10). Higher scores indicate a higher symptom burden. Symptom scores are summed on each day with a maximum daily score of 60. The TSS is calculated by averaging daily sum scores over 7 days, with a maximum TSS of 60.
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Timepoint [2]
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Baseline to Week 24
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Secondary outcome [1]
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Proportion of participants achieving both a peak gastric eosinophil count of =6 eos/hpf and a peak duodenal eosinophil count of =15 eos/hpf
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Assessment method [1]
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Part A, Part B and Part C
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Timepoint [1]
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At Week 24 and At Week 52
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Secondary outcome [2]
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Proportion of participants achieving a peak duodenal eosinophil count of =15 eos/hpf
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Assessment method [2]
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Part A, Part B and Part C
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Timepoint [2]
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At Week 24 and At Week 52
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Secondary outcome [3]
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Absolute change in the EoG/EoD-SQ TSS
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Assessment method [3]
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Part A and Part C
EoG/EoD-SQ is a PRO collected daily via an eDiary. Symptoms are assessed using an 11-point numerical rating scale (0 through 10). Higher scores indicate a higher symptom burden. Symptom scores are summed on each day with a maximum daily score of 60. The TSS is calculated by averaging daily sum scores over 7 days, with a maximum TSS of 60.
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Timepoint [3]
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Baseline to Week 24 and Baseline to Week 52
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Secondary outcome [4]
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Percent change in the EoG/EoD-SQ TSS
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Assessment method [4]
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Part A, Part B and Part C
EoG/EoD-SQ is a PRO collected daily via an eDiary. Symptoms are assessed using an 11-point numerical rating scale (0 through 10). Higher scores indicate a higher symptom burden. Symptom scores are summed on each day with a maximum daily score of 60. The TSS is calculated by averaging daily sum scores over 7 days, with a maximum TSS of 60.
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Timepoint [4]
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Baseline to Week 24 and Baseline to Week 52
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Secondary outcome [5]
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Percent change in peak gastric tissue eosinophil count (eos/hpf)
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Assessment method [5]
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Part A, Part B and Part C
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Timepoint [5]
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Baseline to Week 24 and Baseline to Week 52
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Secondary outcome [6]
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Proportion of participants achieving a peak gastric tissue eosinophil count of <30 eos/hpf
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Assessment method [6]
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Part A, Part B and Part C
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Timepoint [6]
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At Week 24 and At Week 52
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Secondary outcome [7]
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Percent change in peak duodenal tissue eosinophil count (eos/hpf)
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Assessment method [7]
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Part A, Part B and Part C: Assessed for only those with duodenal involvement
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Timepoint [7]
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Baseline to Week 24 and Baseline to Week 52
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Secondary outcome [8]
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Proportion of participants achieving a peak duodenal tissue eosinophil count of <30 eos/hpf
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Assessment method [8]
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Part A, Part B and Part C: Assessed for only those with duodenal involvement
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Timepoint [8]
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At Week 24 and At Week 52
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Secondary outcome [9]
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Absolute change in EoG scores from the EoG Histology Scoring System (EoGHSS)
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Assessment method [9]
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Part A, Part B and Part C
EoGHSS scores evaluate 11 features of gastric tissue. Total score is the sum of features scores divided by the maximum possible score for the biopsy. Total scores range from 0 - 1.
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Timepoint [9]
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Baseline to Week 24 and Baseline to Week 52
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Secondary outcome [10]
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Change in frequency of diarrhea epispodes
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Assessment method [10]
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Assessed for only those with diarrhea at baseline.
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Timepoint [10]
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Baseline at Week 24 and Baseline at Week 52
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Secondary outcome [11]
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Change in frequency of vomiting episodes
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Assessment method [11]
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Assessed for only those with vomiting at baseline
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Timepoint [11]
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Baseline at Week 24 and Baseline at Week 52
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Secondary outcome [12]
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Change in the Normalized Enrichment Scores (NES) for the type 2 inflammation transcriptome signature
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Assessment method [12]
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Part A, Part B and Part C: Assessed on gastric tissue
Normalized Enrichment Score (NES) reflects the degree to which the activity level of a set of transcripts is overrepresented at the extremes (top or bottom) of the entire ranked list of transcripts within a sample and is normalized by accounting for the number of transcripts in the set.
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Timepoint [12]
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Baseline to Week 24 and Baseline to Week 52
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Secondary outcome [13]
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Change in the NES for the type 2 inflammation transcriptome signature
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Assessment method [13]
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Part A, Part B and Part C: Assessed on duodenal tissue from participants with EoD
NES reflects the degree to which the activity level of a set of transcripts is overrepresented at the extremes (top or bottom) of the entire ranked list of transcripts within a sample and is normalized by accounting for the number of transcripts in the set.
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Timepoint [13]
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Baseline to Week 24 and Baseline to Week 52
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Secondary outcome [14]
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Change in the NES for the EoG disease (EoG diagnostic panel (EGDP]) transcriptome signature
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Assessment method [14]
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Part A, Part B and Part C: Assessed on gastric tissue
NES reflects the degree to which the activity level of a set of transcripts is overrepresented at the extremes (top or bottom) of the entire ranked list of transcripts within a sample and is normalized by accounting for the number of transcripts in the set.
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Timepoint [14]
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Baseline to Week 24 and Baseline to Week 52
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Secondary outcome [15]
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Proportion of participants who receive rescue medications or procedures
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Assessment method [15]
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Part A, Part B and Part C
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Timepoint [15]
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At Week 24 and At Week 52
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Secondary outcome [16]
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Proportion of participants achieving a peak gastric eosinophil count of =6 eos/hpf
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Assessment method [16]
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Part C
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Timepoint [16]
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At Week 52
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Secondary outcome [17]
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Incidence of treatment-emergent adverse events (TEAEs)
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Assessment method [17]
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Part A, Part B and Part C
A TEAE is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment.
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Timepoint [17]
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Up to Week 52
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Secondary outcome [18]
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Incidence of treatment-emergent serious adverse events (SAEs)
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Assessment method [18]
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Part A, Part B and Part C
An SAE is any untoward medical occurrence that at any dose:
* Results in death - includes all deaths, even those that appear to be completely unrelated to study drug (eg, a car accident in which a patient is a passenger)
* Is life-threatening
* Requires in-patient hospitalization or prolongation of existing hospitalization
* Results in persistent or significant disability/incapacity
* Is a congenital anomaly/birth defect
* Is an important medical event
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Timepoint [18]
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Up to Week 52
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Secondary outcome [19]
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Incidence of treatment-emergent adverse events of special interest (AESIs)
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Assessment method [19]
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Part A, Part B and Part C
An AESI (serious or non-serious) is one of scientific and medical concern specific to the sponsor's product or program, for which ongoing monitoring and rapid communication by the Investigator to the sponsor can be appropriate. Such an event might warrant further investigation in order to characterize and understand it
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Timepoint [19]
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Up to Week 52
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Secondary outcome [20]
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Incidence of TEAEs leading to permanent discontinuation of study treatment
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Assessment method [20]
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Part A, Part B and Part C
A TEAE is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment.
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Timepoint [20]
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Up to Week 52
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Secondary outcome [21]
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Incidence of anti-drug antibody (ADA)
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Assessment method [21]
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Part A, Part B and Part C
Immunogenicity will be characterized per drug molecule by ADA and NAb status
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Timepoint [21]
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Up to Week 52
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Secondary outcome [22]
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Titer of ADA
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Assessment method [22]
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Part A, Part B and Part C
Immunogenicity will be characterized per drug molecule by ADA and NAb status
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Timepoint [22]
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Up to Week 52
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Secondary outcome [23]
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Incidence of neutralizing antibody (Nab) to dupilumab
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Assessment method [23]
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Part A, Part B and Part C
Immunogenicity will be characterized per drug molecule by ADA and NAb status
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Timepoint [23]
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Up to Week 52
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Secondary outcome [24]
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Concentrations of functional dupilumab in serum at each assessment time point from baseline to end of study
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Assessment method [24]
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The concentrations of functional dupilumab over time will be summarized by descriptive statistics by study arm for the overall population and for adolescent patients.
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Timepoint [24]
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Baseline to Week 64
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Eligibility
Key inclusion criteria
Key
1. Adolescent participants will only be enrolled at study sites in countries/regions as permitted by local regulatory authorities and ethic committees (ECs)
2. Documented endoscopic biopsy supporting a pathologic diagnosis of Eosinophilic gastritis (EoG) at least 3 months prior to screening
3. Baseline endoscopic biopsies with a demonstration of eosinophilic infiltration for a diagnosis of EoG, as defined in the protocol
4. Completed at least 11 of 14 days of EoG/EoD-SQ eDiary data entry in the 2 weeks prior to the baseline visit
5. History (by patient report) of at least 2 episodes of EoG (with or without EoD) symptoms per week in 8 weeks before screening
6. For the 2 weeks prior to baseline visit, an average total symptom score (TSS) of at least of 20 calculated using data from the EoG/EoD-SQ eDiary and an average severity score of at least 4 (on a scale of 0-10) per week for at least 2 of the 6 symptoms, as defined in the protocol.
Key
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Minimum age
12
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Body weight less than 40 kg
2. Prior participation in a dupilumab clinical trial, or past or current treatment with dupilumab
3. Helicobacter pylori infection
4. Any esophageal stricture unable to be passed with a standard, diagnostic, upper endoscope or any critical esophageal stricture that requires dilation at screening
5. History of achalasia, Crohn's disease, eosinophilic colitis, ulcerative colitis, celiac disease, and prior gastric or duodenal surgery
6. Other causes of gastric and, if applicable, duodenal eosinophilia or the following conditions: eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) or hyper-eosinophilic syndrome
7. History of bleeding disorders, esophageal or gastric varices that, in the opinion of the investigator, would put the participant at undue risk for significant complications from an endoscopy procedure
8. Initiation or change of a food-elimination diet regimen or re-introduction of a previously eliminated food group in the 4 weeks prior to the screening visit. Participants on a food-elimination diet must remain on the same diet throughout the study
9. Planned or anticipated use of any prohibited medications and procedures during the study
10. Planned or anticipated major surgical procedure during the study
11. Receiving tube feeding or parenteral nutritional at screening (Part A and B).
NOTE: Other Protocol Defined Inclusion / Exclusion Criteria Apply
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
3/05/2023
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
19/08/2027
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Actual
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Sample size
Target
279
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD
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Recruitment hospital [1]
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Nepean Clinical School - Kingswood
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Recruitment hospital [2]
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Mater Research Ltd - South Brisbane
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Recruitment hospital [3]
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The University of Queensland - Princess Alexandra Hospital (PAH) - Woolloongabba
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Recruitment hospital [4]
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St. Vincent's Hospital - Fitzroy
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Recruitment hospital [5]
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Joondalup Health Campus - Joondalup
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Recruitment hospital [6]
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Coral Sea Clinical Research Institute - North Mackay
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Recruitment postcode(s) [1]
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2747 - Kingswood
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Recruitment postcode(s) [2]
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4101 - South Brisbane
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Recruitment postcode(s) [3]
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4102 - Woolloongabba
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Recruitment postcode(s) [4]
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3065 - Fitzroy
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Recruitment postcode(s) [5]
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6027 - Joondalup
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Recruitment postcode(s) [6]
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4740 - North Mackay
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Recruitment outside Australia
Country [1]
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0
United States of America
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State/province [1]
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Arizona
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Country [2]
0
0
United States of America
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State/province [2]
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California
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Country [3]
0
0
United States of America
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State/province [3]
0
0
Connecticut
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Country [4]
0
0
United States of America
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State/province [4]
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0
Florida
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Country [5]
0
0
United States of America
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State/province [5]
0
0
Illinois
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Country [6]
0
0
United States of America
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State/province [6]
0
0
Iowa
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Country [7]
0
0
United States of America
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State/province [7]
0
0
Kansas
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Country [8]
0
0
United States of America
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State/province [8]
0
0
Maryland
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Country [9]
0
0
United States of America
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State/province [9]
0
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Massachusetts
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Country [10]
0
0
United States of America
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State/province [10]
0
0
Michigan
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Country [11]
0
0
United States of America
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State/province [11]
0
0
Minnesota
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Country [12]
0
0
United States of America
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State/province [12]
0
0
Nebraska
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Country [13]
0
0
United States of America
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State/province [13]
0
0
Nevada
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Country [14]
0
0
United States of America
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State/province [14]
0
0
New Hampshire
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Country [15]
0
0
United States of America
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State/province [15]
0
0
New York
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Country [16]
0
0
United States of America
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State/province [16]
0
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North Carolina
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Country [17]
0
0
United States of America
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State/province [17]
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Ohio
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Country [18]
0
0
United States of America
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State/province [18]
0
0
Oklahoma
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Country [19]
0
0
United States of America
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State/province [19]
0
0
Oregon
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Country [20]
0
0
United States of America
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State/province [20]
0
0
Pennsylvania
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Country [21]
0
0
United States of America
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Tennessee
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Country [22]
0
0
United States of America
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Texas
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Country [23]
0
0
United States of America
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State/province [23]
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Utah
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Country [24]
0
0
United States of America
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State/province [24]
0
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Washington
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Country [25]
0
0
Italy
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State/province [25]
0
0
Bari
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Country [26]
0
0
Italy
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State/province [26]
0
0
Milano
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Country [27]
0
0
Italy
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State/province [27]
0
0
Palermo
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Country [28]
0
0
Italy
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State/province [28]
0
0
Pisa
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Country [29]
0
0
Italy
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State/province [29]
0
0
Roma
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Country [30]
0
0
Italy
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State/province [30]
0
0
Rome
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Country [31]
0
0
Italy
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State/province [31]
0
0
Rozzano
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Country [32]
0
0
Japan
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State/province [32]
0
0
Fukuoka
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0
0
Japan
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State/province [33]
0
0
Gifu
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0
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Japan
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State/province [34]
0
0
Gunma
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0
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Japan
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State/province [35]
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0
Hiroshima
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0
0
Japan
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State/province [36]
0
0
Hyogo
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Country [37]
0
0
Japan
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State/province [37]
0
0
Kanagawa
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0
0
Japan
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State/province [38]
0
0
Okayama
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Country [39]
0
0
Japan
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State/province [39]
0
0
Tokyo
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Country [40]
0
0
Japan
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State/province [40]
0
0
Yamagata
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Country [41]
0
0
Poland
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State/province [41]
0
0
Rzeszow
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Country [42]
0
0
Poland
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State/province [42]
0
0
Warsaw
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Country [43]
0
0
Poland
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State/province [43]
0
0
Wroclaw
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Regeneron Pharmaceuticals
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Address
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Country
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Other collaborator category [1]
0
0
Commercial sector/industry
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Name [1]
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Sanofi
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Address [1]
0
0
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Country [1]
0
0
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Ethics approval
Ethics application status
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Summary
Brief summary
The study is researching an experimental drug called dupilumab. The study is focused on participants with active eosinophilic gastritis (EoG) with or without eosinophilic duodenitis (EoD). Participants with EoD only are not eligible for enrollment. EoG and EoD are uncommon, persistent, allergic/immune diseases in which eosinophils (a type of white blood cell) gather in large numbers in the stomach and small intestine and cause inflammation and damage. The aim of the study is to evaluate the effect of dupilumab on relieving EoG (with or without EoD) symptoms and reducing inflammation in the stomach and, if applicable, small intestine in adults and adolescents aged 12 years and older, compared to placebo. The study is looking at several other research questions, including: * What side effects may happen from taking the study drug * How much study drug is in your blood at different times * Whether the body makes antibodies against the study drug (which could make the drug less effective or could lead to side effects)
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Trial website
https://clinicaltrials.gov/study/NCT05831176
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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0
Clinical Trial Management
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Address
0
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Regeneron Pharmaceuticals
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Country
0
0
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Phone
0
0
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Fax
0
0
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Email
0
0
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Contact person for public queries
Name
0
0
Clinical Trials Administrator
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Address
0
0
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Country
0
0
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Phone
0
0
844-734-6643
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Fax
0
0
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Email
0
0
[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
All Individual Patient Data (IPD) that underlie publicly available results will be considered for sharing.
Supporting document/s available: Study protocol, Statistical analysis plan (SAP), Informed consent form (ICF), Clinical study report (CSR), Analytic code
Query!
When will data be available (start and end dates)?
When Regeneron has received marketing authorization from major health authorities (e.g., FDA, European Medicines Agency (EMA), Pharmaceuticals and Medical Devices Agency (PMDA), etc.) for the product and indication, has made results publicly available (e.g., scientific publication, scientific conference, clinical trial registry), has the legal authority to share the data, and has ensured the ability to protect participant privacy.
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Available to whom?
Qualified researchers can submit a proposal for access to individual patient or aggregate level data from a Regeneron-sponsored clinical trial through Vivli. Regeneron's Independent Research Request Evaluation Criteria can be found at: https://www.regeneron.com/sites/default/files/Regeneron-External-Data-Sharing-Policy-and-Independent-Research-Request-Evaluation-Criteria.pdf
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Available for what types of analyses?
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How or where can data be obtained?
IPD available at link: https://vivli.org/
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT05831176