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Dietary intervention induced histologic remission of eosinophilic esophagitis
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Dietary interventions, especially elemental diets and 6-food elimination diets, were effective in inducing histologic remission in patients with eosinophilic esophagitis, according to recent study data.
Researchers from Spain performed a systematic review and meta-analysis on the efficacy of dietary treatments for eosinophilic esophagitis (EoE), sourcing 581 relevant studies from PubMed, Embase and Scopus databases published June 2013 or earlier, 33 of which were included in the summary. Data were analyzed on 1,317 EoE patients (1,128 children) who underwent any dietary interventions followed by histologic evaluation, including exclusive feeding with amino acid-based elemental formulas, allergy test result-directed food elimination diets, 6-food elimination diets (SFED) and 44 others. EoE remission was defined as a peak eosinophil count of less than 15 eosinophils/high-power field in post-treatment esophageal biopsy.
Overall effectiveness of any dietary intervention’s ability to induce histologic remission was 66.3% (95% CI, 56.9%-75%), with no significant difference between pediatric (67.2%) and adult patients (63.6%). Of 429 patients who underwent elemental diet therapy, histologic remission rate was 90.8% (95% CI, 84.7%-95.5%) and was highly effective in children (n=411; 90.4%) and adults (n=18; 94.4%). Of 626 patients who underwent allergy test result-directed food elimination diet therapy, overall efficacy was 45.5% (95% CI, 35.4%-55.7%), but significantly greater in children (n=594; 47.9%) than adults (n=32; 32.2%). Of 197 patients who underwent SFED, overall efficacy was 72.1% (95% CI, 65.8%-78.1%), with homogenous results between children (n=75; 72.8%) and adults (n=122; 71.3%).
“Our research has demonstrated that dietary modifications are an effective treatment alternative for inducing histologic remission of EoE, reinforcing the idea that this strategy should be considered as a first-line therapy in both children and adults affected by the disease,” the researchers wrote, adding that SFED appeared to be the most efficacious dietary intervention.
Disclosure: The researchers report no relevant financial disclosures.
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