Applying REMODEL Findings to Esophageal Function in EoE

In ‘Applying REMODEL Findings to Esophageal Function in EoE,’ our panel explores findings from the Phase 4 REMODEL study and their potential application in clinical practice. The experts discuss the study's use of esophageal distensibility as an outcome, describing it as a measure of how well the esophagus accommodates a food bolus and emphasizing that it provides information beyond eosinophil counts and dysphagia.

The panel reviews the improvement in esophageal diameter observed with dupilumab compared with placebo, noting that patients with greater baseline narrowing demonstrated larger changes. Faculty emphasize that distensibility is related to, but not synonymous with, fibrosis. The findings therefore provide a promising signal regarding esophageal remodeling and function while longer-term data remain important for understanding effects on fibrotic complications.

In an additional roundtable, the experts discuss how these findings translate across different clinical settings. EndoFLIP can provide an objective assessment of esophageal caliber when available, particularly when symptoms persist despite histologic remission or apparently normal endoscopy. In practices without EndoFLIP, clinicians describe using careful endoscopic assessment, dilation balloons, or bougies to identify subtle narrowing that may otherwise be difficult to appreciate. The panel highlights the clinical significance of increasing esophageal diameter without mechanical dilation and places the reported improvement into the context of the relatively small caliber changes that can meaningfully affect swallowing.

Our next episode, ‘Long-Term Budesonide Oral Suspension Therapy in EoE,’ examines extended efficacy, histologic control, endoscopic response, and tolerability with swallowed corticosteroid therapy.