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5 days ago
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A recent study has found that food bolus impaction or strictures predict most episodes of oesophageal perforation, a rare but serious complication of eosinophilic esophagitis (EoE) that occurs in about 2 percent of cases. This suggests that patients with fibrostenotic disease due to longer duration of symptoms are at increased risk.

Viscous budesonide ranks as most effective therapy for EoE in meta-analysis

07 Sep 2017

Viscous budesonide appears to be the most effective pharmacologic therapy for eosinophilic esophagitis (EoE) among several pharmacologic treatments, including budesonide suspension, fluticasone, prednisone, esomeprazole and mepolizumab, according to the results of a network meta-analysis.

Researchers searched multiple electronic databases for studies evaluating pharmacologic treatments for EoE and performed a random-effects network meta-analysis to identify the most effective therapy, with the ranking probability for the efficacy of each treatment analysed. A subgroup analysis was also carried out among studies that excluded gastroesophageal reflux disease or proton pump inhibitor therapy-responsive oesophageal eosinophilia, and among studies conducted in paediatric and adult populations.

A total of 11 studies involving 456 patients and comparing six pharmacologic treatments (budesonide suspension and viscous, fluticasone, prednisone, esomeprazole, and mepolizumab) against placebo were included in the analysis.

Pooled data demonstrated the superiority of budesonide viscous, budesonide suspension and fluticasone over placebo. The rank order of efficacy among the reported pharmacologic treatments was as follows: budesonide viscous, esomeprazole, prednisone, budesonide suspension, fluticasone, mepolizumab and placebo.

Results were robust on inconsistency model analysis and node-splitting analysis.

In the subgroup analysis, prednisone was the most effective among studies that excluded gastroesophageal reflux disease or proton pump inhibitor-responsive oesophageal eosinophilia. On the other hand, budesonide suspension and esomeprazole were the most effective pharmacologic treatments and among studies in paediatric and adult populations, respectively.

Additional comparative studies, especially among different topical steroid therapies, are warranted to confirm the present data, researchers said.

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Most Read Articles
5 days ago
There appears to be an association between waterpipe tobacco smoking and gastro-oesophageal reflux disease (GERD), which is a known risk factor for oesophageal adenocarcinoma, a study has shown.
Tristan Manalac, 6 days ago
An 8-week regimen of sofosbuvir-velpatasvir-voxilaprevir combination is not noninferior to a 12-week regimen of sofosbuvir-velpatasvir for patients with chronic hepatitis C virus (HCV) infection, report two recent phase 3 open-label trials.
2 days ago
The additional use of intermittent low-energy diet (LED) or daily meal replacements after a mean 10-percent weight loss and 1-year maintenance effectively maintains weight loss in obese patients with knee osteoarthritis for 3 years, according to a recent study.
5 days ago
A recent study has found that food bolus impaction or strictures predict most episodes of oesophageal perforation, a rare but serious complication of eosinophilic esophagitis (EoE) that occurs in about 2 percent of cases. This suggests that patients with fibrostenotic disease due to longer duration of symptoms are at increased risk.