How Effective is PPI Tx for Esophageal Eosinophilia?
HealthDay News — About half of patients with symptomatic esophageal eosinophilia have clinicohistologic remission with proton pump inhibitor (PPI) therapy, according to a review published in the January issue of Clinical Gastroenterology and Hepatology.
Alfredo J. Lucendo, MD, PhD, from the Hospital General de Tomelloso in Spain, and colleagues conducted a systematic review to examine the efficacy of PPI therapy for patients with symptomatic esophageal eosinophilia (>15 eos/high-power field). Data were included from 33 studies (11 prospective studies) of 619 patients with symptomatic esophageal eosinophilia (188 children and 431 adults).
The researchers found that PPI therapy correlated with clinical response and histologic remission in 60.8 and 50.5% of patients, respectively (I² = 80.2 and 67.5%, respectively). There were no differences based on study population, publication type, or quality. The effectiveness of PPI was nonsignificantly higher in prospective studies (52.6 versus 39.1%), when administered twice versus once daily (55.9 versus 49.7%), and with pathologic pH monitoring (65.4 versus 49.3%). There was a significant publication bias in favor of studies reporting histologic responses to PPIs.
"PPI therapy induces clinicohistologic remission in half of patients with symptomatic esophageal eosinophilia," the authors write. "This finding should be interpreted with caution because of poor-quality evidence, heterogeneity, and publication bias."