Network meta-analysis ranks EoE treatments by efficacy, safety

A systematic review and network meta-analysis of 48 randomized controlled trials (3,963 participants) compared pharmacologic, dietary, and mechanical treatments for eosinophilic esophagitis. High-frequency dupilumab and swallowed topical corticosteroids showed the largest improvements in symptoms and quality of life, while certain biologics and epicutaneous immunotherapy were not different from placebo for symptoms; four- and six-food elimination diets showed modest, low-certainty symptom benefit over one-food elimination with greater burden. The authors note that histologic improvement did not guarantee improvement in patient-important outcomes.

Most relevant for: Clinicians managing children and adults with eosinophilic esophagitis who are choosing among pharmacologic, dietary, or mechanical treatment options.

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