Effect of budesonide oral suspension on dysphagia and esophageal inflammation in eosinophilic esophagitis: a systematic review and meta-analysis - Summary - MDSpire
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Effect of budesonide oral suspension on dysphagia and esophageal inflammation in eosinophilic esophagitis: a systematic review and meta-analysis
To evaluate the efficacy and safety of Budesonide Oral Suspension (BOS) in improving dysphagia and achieving histological remission in patients with Eosinophilic Esophagitis (EoE).
Approach:
Study Design: Systematic review and meta-analysis following PRISMA 2020 guidelines.
Search Strategy: Comprehensive search across PubMed, Scopus, Web of Science, and EMBASE from inception to October 14, 2024.
Inclusion Criteria: Randomized controlled trials (RCTs) of pediatric or adult EoE patients treated with BOS (1–2 mg twice daily) versus placebo for ≥12 weeks.
Key Findings:
BOS significantly improved histologic outcomes compared to placebo (MD = –54.62 eos/hpf; 95% CI –68.19 to –41.05).
Endoscopic severity improved with BOS (MD = –1.68; 95% CI –3.09 to –0.26).
Patient-reported symptom severity improved (pooled MD = –3.29 points; 95% CI –6.17 to –0.40).
Treatment-emergent adverse events were similar between groups, with rare serious adverse events.
Interpretation:
BOS effectively reduces esophageal inflammation and alleviates dysphagia in EoE, supporting its use as a first-line topical therapy.
Limitations:
Only four RCTs were included, limiting the breadth of evidence.
Different validated symptom instruments were used across trials, affecting the composite symptom-severity estimate.
Conclusion:
BOS is a viable first-line treatment for reducing inflammation and improving symptoms in EoE.
by Darío S. López Delgado, Carlos A. Narváez, Gloria L. Chapues-Andrade, María A. Matus-Hernández, Veraliz González-Hidalgo, Gerson Diaz-Gonzales, Oriana Rivera-Lozada, Joshuan J. Barboza
