Theodore Rokkas1, Yaron Niv2, Peter Malfertheiner3,4. 1. Gastroenterology Clinic, Henry Dunant Hospital, Athens, Greece. 2. Tel Aviv University, Ministry of Health, Tel Aviv, Israel. 3. Ludwig Maximilian University, Medical Clinic II, Munich. 4. Otto von Guericke University, Clinic of Gastroenterology, Hepatology and Infectiology, Magdeburg, Germany.
Abstract
BACKGROUND: Network meta-analysis is used as a data synthesizer, incorporating direct and indirect evidence about treatments in a series of randomized control trials. OBJECTIVE: To evaluate the comparative efficacy of various treatments for eosinophilic esophagitis (EoE). METHODS: We performed a network meta-analysis to combine direct and indirect data to investigate the efficiency of drug therapies, which were evaluated in relevant randomized control trials for EoE. RESULTS: Seventeen eligible studies (14 two-arm and 3 multiple-arm) were introduced to the meta-analysis. A total of 1011 patients were included, in whom 15 therapeutic interventions were used, namely: (1) budesonide oral suspension, (2) budesonide 1 mg orodispersible tablet twice daily, (3) budesonide 2 mg orodispersible tablet twice daily, (4) esomeprazole, (5) fluticasone, (6) nebulized steroid, (7) placebo, (8) prednisone, (9) anti-IL-5-mab (mepolizumab), (10) anti-IL-5-mab [reslizumab(1), ie, 1 mg/kg], (11) anti-IL-5-mab [reslizumab(2), ie, 2 mg/kg], (12) anti-IL-5-mab [reslizumab(3), ie, 3 mg/kg], (13) anti-IL-13-mab (QAX 576), (14) anti-IL-13-mab [RCP 4046 (180)], and (15) anti-IL-13-mab [RCP 4046 (360)]. Budesonide 1 mg orodispersible tablet twice daily showed the highest efficacy (SUCRA 0.91), whereas placebo was the least effective. In adult patients budesonide 1 mg orodispersible tablet twice daily remained the optimal treatment approach, whereas the corresponding therapeutic approach in pediatric patients was fluticasone. CONCLUSIONS: This meta-analysis showed that budesonide 1 mg orodispersible tablet twice daily was the best treatment for EoE, as it was the most effective. This treatment remained the optimal approach in adult patients, whereas fluticasone was the best treatment in pediatric patients.
BACKGROUND: Network meta-analysis is used as a data synthesizer, incorporating direct and indirect evidence about treatments in a series of randomized control trials. OBJECTIVE: To evaluate the comparative efficacy of various treatments for eosinophilic esophagitis (EoE). METHODS: We performed a network meta-analysis to combine direct and indirect data to investigate the efficiency of drug therapies, which were evaluated in relevant randomized control trials for EoE. RESULTS: Seventeen eligible studies (14 two-arm and 3 multiple-arm) were introduced to the meta-analysis. A total of 1011 patients were included, in whom 15 therapeutic interventions were used, namely: (1) budesonide oral suspension, (2) budesonide 1 mg orodispersible tablet twice daily, (3) budesonide 2 mg orodispersible tablet twice daily, (4) esomeprazole, (5) fluticasone, (6) nebulized steroid, (7) placebo, (8) prednisone, (9) anti-IL-5-mab (mepolizumab), (10) anti-IL-5-mab [reslizumab(1), ie, 1 mg/kg], (11) anti-IL-5-mab [reslizumab(2), ie, 2 mg/kg], (12) anti-IL-5-mab [reslizumab(3), ie, 3 mg/kg], (13) anti-IL-13-mab (QAX 576), (14) anti-IL-13-mab [RCP 4046 (180)], and (15) anti-IL-13-mab [RCP 4046 (360)]. Budesonide 1 mg orodispersible tablet twice daily showed the highest efficacy (SUCRA 0.91), whereas placebo was the least effective. In adult patientsbudesonide 1 mg orodispersible tablet twice daily remained the optimal treatment approach, whereas the corresponding therapeutic approach in pediatric patients was fluticasone. CONCLUSIONS: This meta-analysis showed that budesonide 1 mg orodispersible tablet twice daily was the best treatment for EoE, as it was the most effective. This treatment remained the optimal approach in adult patients, whereas fluticasone was the best treatment in pediatric patients.
Authors: Ian D Pavord; Elisabeth H Bel; Arnaud Bourdin; Robert Chan; Joseph K Han; Oliver N Keene; Mark C Liu; Neil Martin; Alberto Papi; Florence Roufosse; Jonathan Steinfeld; Michael E Wechsler; Steven W Yancey Journal: Allergy Date: 2021-09-16 Impact factor: 14.710
Authors: Stephan Miehlke; Christoph Schlag; Alfredo J Lucendo; Luc Biedermann; Cecilio Santander Vaquero; Christoph Schmoecker; Jamal Hayat; Petr Hruz; Constanza Ciriza de Los Rios; Albert Jan Bredenoord; Michael Vieth; Alain Schoepfer; Stephen Attwood; Ralph Mueller; Sarah Burrack; Roland Greinwald; Alex Straumann Journal: United European Gastroenterol J Date: 2022-04 Impact factor: 4.623