Original articleSystematic reviews and meta-analysesEfficacy of Proton Pump Inhibitor Drugs for Inducing Clinical and Histologic Remission in Patients With Symptomatic Esophageal Eosinophilia: A Systematic Review and Meta-Analysis
Section snippets
Methods
This systematic review has been registered in the PROSPERO International prospective register of systematic reviews (www.crd.york.ac.uk/PROSPERO; register no. CRD42015017569), and was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements.17
Results
The search strategy yielded 1008 references; 961 were excluded after examining the title and abstract because they did not fulfill the inclusion criteria. Among the remaining 47 documents retrieved for complete evaluation, 14 were excluded because of a lack of data for calculations (11 documents) or either repeated or duplicated information (3 documents). Finally, 33 studies (comprising 28 full reports11, 12, 13, 14, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42
Discussion
The present systematic review and meta-analysis shows that PPIs are effective drugs for achieving complete remission in half of patients with symptomatic esophageal eosinophilia compatible with EoE. Interestingly, the prevalence of histologic remission on PPI therapy reported here is slightly higher than that reported in a previous nonsystematic review article, especially in children (23%–40%).16 This discrepancy likely is related to the inclusion of case reports and abstracts because the
References (53)
- et al.
Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment
Gastroenterology
(2007) - et al.
Predictors of response to proton pump inhibitor therapy among children with significant esophageal eosinophilia
J Pediatr
(2009) - et al.
Esophageal eosinophilic infiltration responds to proton pump inhibition in most adults
Clin Gastroenterol Hepatol
(2011) - et al.
PRISMA declaration: a proposal to improve the publication of systematic reviews and meta-analyses
Med Clin (Barc)
(2010) - et al.
Eosinophilic infiltration of the esophagus: gastroesophageal reflux versus eosinophilic esophagitis in children–discussion on daily practice
J Pediatr Surg
(2004) - et al.
Eosinophilic esophagitis in adults: an emerging problem with unique esophageal features
Gastrointest Endosc
(2004) - et al.
Eosinophilic esophagitis: is it also a surgical disease?
J Pediatr Surg
(2013) - et al.
Comparison of endoscopic and histologic response in patients with eosinophilic esophagitis treated with proton pump inhibition, topical fluticasone, and dietary elimination
Gastroenterology
(2009) - et al.
Esophageal eosinophilia associated with congenital esophageal atresia/stenosis and its responsiveness to proton pump inhibitor
J Allergy Clin Immunol
(2015) - et al.
Eosinophilic esophagitis: updated consensus recommendations for children and adults
J Allergy Clin Immunol
(2011)
Esophageal eosinophilia with dysphagia. A distinct clinicopathologic syndrome
Dig Dis Sci
Idiopathic eosinophilic esophagitis: a frequently overlooked disease with typical clinical aspects and discrete endoscopic findings
Schweiz Med Wochenschr
Escalating incidence of eosinophilic esophagitis: a 20-year prospective, population-based study in Olten County, Switzerland
J Allergy Clin Immunol
Prevalence of eosinophilic oesophagitis in adult patients in a central region of Spain
Eur J Gastroenterol Hepatol
Prevalence of eosinophilic esophagitis in the United States
Clin Gastroenterol Hepatol
ACG clinical guideline: evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE)
Am J Gastroenterol
Management guidelines of eosinophilic esophagitis in childhood
J Pediatr Gastroenterol Nutr
Thoughts on the complex relationship between gastroesophageal reflux disease and eosinophilic esophagitis
Am J Gastroenterol
Eosinophils in the esophagus–peptic or allergic eosinophilic esophagitis? Case series of three patients with esophageal eosinophilia
Am J Gastroenterol
Treatment with high-dose proton pump inhibitors helps distinguish eosinophilic esophagitis from noneosinophilic esophagitis
J Pediatr Gastroenterol Nutr
Proton pump inhibitor-responsive esophageal eosinophilia: a historical perspective on a novel and evolving entity
Rev Esp Enferm Dig
Review article: proton pump inhibitor therapy for suspected eosinophilic oesophagitis
Aliment Pharmacol Ther
Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group
JAMA
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies
Epidemiology
Measuring inconsistency in meta-analyses
BMJ
Cited by (248)
Eosinophilic Esophagitis: What the Otolaryngologist Needs to Know
2024, Otolaryngologic Clinics of North AmericaPharmacologic Management of Eosinophilic Esophagitis
2024, Immunology and Allergy Clinics of North AmericaClinical Evaluation of the Child with Eosinophilic Esophagitis
2024, Immunology and Allergy Clinics of North AmericaNumber of bottles of esophageal biopsies in the evaluation of eosinophilic esophagitis and clinical outcomes; Bottle evaluation EoE
2023, Clinics and Research in Hepatology and GastroenterologyTreatment Trends for Eosinophilic Esophagitis and the Other Eosinophilic Gastrointestinal Diseases: Systematic Review of Clinical Trials: Future Treatments for EGIDS: Systematic Review
2023, Digestive and Liver DiseaseCitation Excerpt :However, we observed a lack of interest in evaluating these novel drugs in EoC, which will likely remain without labelled therapeutic options in the longer term. PPIs are currently considered as one of the possible first line treatments for EoE [5,7,8] because they are effective in controlling esophageal inflammation and symptoms [22,23]. However, since 2008, only five trials registered on clinicaltrials.gov investigated treatment with PPIs, either as monotherapy or in combination with other treatments.
Conflicts of interest The authors disclose no conflicts.