Lancet Gastroenterol Hepatol

Etrasimod improves symptoms and histology in eosinophilic oesophagitis

May 29, 2025

Etrasimod 2 mg achieved significant reductions in esophageal eosinophilia and improved endoscopic findings, with a favorable safety profile. These findings provide the first evidence that S1P receptor modulation is a viable therapeutic target in eosinophilic oesophagitis, addressing an unmet need for effective, targeted oral therapies in this population.

Study details: The double-blind, placebo-controlled, randomized phase 2 VOYAGE trial (NCT04682639) enrolled adults (18–65 years) with histologically active eosinophilic oesophagitis across 64 sites in five countries. Participants were randomized (3:3:2) to receive etrasimod 2 mg, etrasimod 1 mg, or placebo orally once daily for 24 weeks, followed by a 28-week extension. The primary endpoint was percentage change from baseline in esophageal peak eosinophil count (PEC) at week 16. Safety was monitored through week 52.

Results: At week 16, median percentage change in PEC was -58.4% for etrasimod 2 mg (p = 0.010 vs. placebo), -39.4% for etrasimod 1 mg (p = 0.29), and -21.5% for placebo. Etrasimod 2 mg also led to sustained histologic and endoscopic improvements over 52 weeks. The most common adverse events were GI disorders, with mild or moderate bradycardia reported less frequently. No serious adverse events or deaths occurred.

Source:

Dellon ES, et al. (2025, May 14). Lancet Gastroenterol Hepatol. Etrasimod as a treatment for eosinophilic oesophagitis (VOYAGE): a double-blind, placebo-controlled, randomised, phase 2 trial. https://pubmed.ncbi.nlm.nih.gov/40381637/