Meta Analysis Of The Efficacy And Safety Of Steroids In The Treatment Of Eosinophilic Esophagitis

Objective:To evaluate the efficacy and safety of steroids in the treatment of eosinophilic esophagitis.Methods:Pub Med,Cochrane Library,Embase,China knowledge Network(CNKI),Wanfang data knowledge Ser vice platform and VIP full-text Database(VIP)were searched by computer,and the related literatures were searched.The data were merged and analyzed by Rev.Man5.4.1 and Stata14.0 software。Results:A total of 906 patients were enrolled in 9 randomized controlled trials,including589 patients in the trial group and 317 patients in the placebo group.The results of Meta analysis showed that,compared with the control group,histological remission[RR=23.53,95%CI=(13.68,40.44),p < 00001],average change of eosinophil count[MD=-164.37,95%CI(-255.66～-73.08),p < 0.0001],Clinical response [RR=3.20,95%CI=(2.29,4.47),p<0.0001],Endoscopic changes[MD=-2.93,95%CI(-3.28～-2.58),p<0.0001],Drug-related adverse event was Candida infection[RR=7.71,95%CI=(3.95,15.07),p<0.0001]。Conclusion:Steroids were significantly superior to placebo in histological remission,average change of eosinophil count,Clinical response and Endoscopic changes.The main adverse reactions were oral and pharyngeal Candida infection,mostly mild to moderate.Normal after antifungal treatment.This series of clinical trials show that steroids are an ideal drug choice for the treatment of eosinophilic esophagitis,which is worthy of clinical application.