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Steroids therapy for eosinophilic esophagitis: Systematic review and meta‐analysis
Author(s) -
Tan Nian Di,
Xiao Ying Lian,
Chen Min Hu
Publication year - 2015
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12265
Subject(s) - medicine , eosinophilic esophagitis , meta analysis , randomized controlled trial , adverse effect , medline , systematic review , confidence interval , esophagitis , gastroenterology , disease , reflux , political science , law
Objective We designed this systematic review and meta‐analysis aiming to clarify the advantage of steroid therapy compared with non‐steroid therapy for the treatment of eosinophilic esophagitis ( EoE ). Methods P ub M ed, EMBASE , M edline, ISI W eb of S cience and the C ochrane D atabase of S ystematic Reviews were searched to identify relevant randomized controlled trials ( RCTs ) comparing steroid and non‐steroid therapy, and retrospective and prospective trials on steroid therapy for EoE . R ev M an 5.2 was used for the analysis. Weighted mean difference and 95% confidence interval (CI) were estimated and pooled using meta‐analysis methods. Results Six RCTs including 193 participants fulfilled the inclusion criteria for meta‐analysis, and another two RCTs , three prospective and five retrospective trials were included in systematic review. Meta‐analysis showed that topical steroids significantly decreased the mean and peak esophageal eosinophils (EOS) count compared to non‐steroid therapy ( MD mean = −23.41, 95% CI mean −42.08–−4.73, P = 0.01 and MD peak = −51.27, 95% CI peak −78.62–−23.92, P = 0.0002). There were 14 trials showing the efficacy of steroids on decreasing the EOS count, 10 showing the amelioration of symptoms, and five showing endoscopic improvement. Only mild adverse events were reported for topical steroids. Conclusions Steroids are effective on decreasing the EOS count in EoE patients . Its value in ameliorating symptoms and endoscopic changes remains undetermined due to the lack of comparable criteria.