Efficacy of Dietary Therapy for Eosinophilic Esophagitis in Children and Adults: An Updated Systematic Review and Meta-Analysis.

Autor:	Arias Á; Research Unit Complejo Hospitalario La Mancha Centro, 13600 Alcázar de San Juan, Spain.; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45004 Toledo, Spain.; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEREHD), 28006 Madrid, Spain.; Instituto de Investigación Sanitaria Princesa, 20006 Madrid, Spain., Tejera-Muñoz A; Research Unit Complejo Hospitalario La Mancha Centro, 13600 Alcázar de San Juan, Spain.; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45004 Toledo, Spain., Gutiérrez-Ramírez L; Research Unit Complejo Hospitalario La Mancha Centro, 13600 Alcázar de San Juan, Spain.; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45004 Toledo, Spain.; Fundación del Hospital Nacional de Parapléjicos para la Investigación y la Integración, 45007 Toledo, Spain., Molina-Infante J; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEREHD), 28006 Madrid, Spain.; Instituto de Investigación Sanitaria Princesa, 20006 Madrid, Spain.; Department of Gastroenterology, Hospital Universitario San Pedro de Alcantara, 10003 Caceres, Spain., Lucendo AJ; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45004 Toledo, Spain.; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEREHD), 28006 Madrid, Spain.; Instituto de Investigación Sanitaria Princesa, 20006 Madrid, Spain.; Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, 13700 Ciudad Real, Spain.
Jazyk:	angličtina
Zdroj:	Nutrients [Nutrients] 2024 Jul 11; Vol. 16 (14). Date of Electronic Publication: 2024 Jul 11.
DOI:	10.3390/nu16142231
Abstrakt:	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 (I 2 ); 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.
Databáze:	MEDLINE
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