Efficacy of Etrasimod for Eosinophilic Esophagitis Continues Beyond the Induction Period

Patients with eosinophilic esophagitis (EoE) who continued treatment with etrasimod for 52 weeks maintained the improvements in endoscopic and histologic features and the decrease in symptom severity achieved during induction therapy in the VOYAGE trial.

Etrasimod, an investigational, oral selective sphingosine-1-phosphate (S1P)–receptor modulator, has been developed for the treatment of immune-mediated inflammatory disorders such as ulcerative colitis. Data from the phase 2 VOYAGE trial recently demonstrated that etrasimod was effective for the treatment of adults with EoE, causing marked reductions in peak eosinophil counts and improvements in endoscopic features by week 16 after the initiation of treatment.

During Digestive Disease Week 2024, Evan S. Dellon, MD, MPH, professor in the Division of Gastroenterology and Hepatology at the University of North Carolina Medical School, in Chapel Hill, presented results from the 28-week extension period of the trial, which showed that improvements were maintained at week 52. Of 108 patients who were initially randomized to receive estrasimod or placebo, 85 entered the extension period, with 30 and 31 continuing etrasimod in daily doses of 2 mg and 1 mg, respectively. Data from the extension period showed a dose-dependent effect, with reductions in eosinophil counts and improvements in histologic severity and endoscopic features maintained in those who received the 2 mg-dose for the full duration of the study. Quality of life metrics reported by patients in the trial also improved during induction therapy in those who took the 2-mg dose, but this benefit was sustained long-term in all patients who continued etrasimod, regardless of dose.

Dellon and co-authors noted that etrasimod was well tolerated in the trial, with a safety profile that was consistent with the use of the medication for other indications, including ulcerative colitis. Etrasimod demonstrated a manageable safety profile throughout the study period, with no new adverse events reported during the extension phase.