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- Title
Efficacy of Dietary Therapy for Eosinophilic Esophagitis in Children and Adults: An Updated Systematic Review and Meta-Analysis.
- Authors
Arias, Ángel; Tejera-Muñoz, Antonio; Gutiérrez-Ramírez, Lucía; Molina-Infante, Javier; Lucendo, Alfredo J.
- Abstract
Background: Several dietary approaches have been used to induce remission in patients with eosinophilic esophagitis (EoE), yielding varied results. Methods: We searched the MEDLINE, EMBASE, and Scopus databases up to May 2024 to identify studies including dietary interventions for EoE used as monotherapy. Summary estimates with 95% CIs for achieving <15 eosinophils/HPF were calculated for each approach. Fixed or random effects models were used depending on heterogeneity (I2); publication bias risks were assessed using funnel plot analyses. Subgroup analyses results were compared using meta-regression. Results: Forty-three studies with 2825 patients were included in quantitative summaries. The overall rate of histologic remission was 60.6% (95% CI, 54.6–66.5%). Effectiveness rates were 94.5% (95% CI, 92.3–96.4%) for elemental diets, 63.9% (95% CI, 58.5–69.2%) for six-food elimination diets, 54.7% (95% CI, 45.7–63.6%) for four-food elimination diets, 44.3% (95% CI, 36.1–52.8%) for two-food elimination diets, 46.4% (95% CI, 40–52.9%) for one-food elimination diets, and 39.5% (95% CI, 30.3–49.2%) for allergy testing-directed food elimination diets. Overall, superior efficacy was noted in children than in adults and in retrospective compared to prospective studies. Conclusion: Diet therapy remains an effective therapeutic asset for pediatric and adult patients with EoE, with increasing efficacy noted as the levels of dietary restriction increase.
- Subjects
MEDICAL information storage &; retrieval systems; ELIMINATION diets; EOSINOPHILIC esophagitis; TREATMENT effectiveness; META-analysis; DISEASE remission; DESCRIPTIVE statistics; SYSTEMATIC reviews; MEDLINE; PEDIATRICS; HISTOLOGICAL techniques; CONFIDENCE intervals; DIET; CHILDREN; ADULTS
- Publication
Nutrients, 2024, Vol 16, Issue 14, p2231
- ISSN
2072-6643
- Publication type
Article
- DOI
10.3390/nu16142231