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Systematic review with meta-analysis: endoscopic dilation is highly effective and safe in children and adults with eosinophilic oesophagitis.

Publication ,  Journal Article
Moawad, FJ; Molina-Infante, J; Lucendo, AJ; Cantrell, SE; Tmanova, L; Douglas, KM
Published in: Alimentary pharmacology & therapeutics
July 2017

Oesophageal dilation is frequently used as an adjunct treatment to alleviate symptoms that develop from fibrostenotic remodelling in eosinophilic oesophagitis (EoE). Earlier reports described an increased risk of complications associated with dilation.Perform a systematic review and meta-analysis to assess the efficacy and safety of endoscopic dilation in children and adults with EoE.Professional librarians searched MEDLINE, EMBASE, the Cochrane library, Scopus, and Web of Science for articles in any language describing studies of dilation in EoE through December 2016. Studies were selected and data were abstracted independently and in duplicate. Random effects modelling was used to generate summary estimates for clinical improvement and complications (haemorrhage, perforation, hospitalisation, and death).The search resulted in 3495 references, of which 27 studies were included in the final analysis. The studies described 845 EoE patients, including 87 paediatric patients, who underwent a total of 1820 oesophageal dilations. The median number of dilations was 3 (range: 1-35). Clinical improvement occurred in 95% of patients (95% CI: 90%-98%, I2 : 10%, 17 studies). Perforation occurred in 0.38% (95% CI: 0.18%-0.85%, I2 : 0%, 27 studies), haemorrhage in 0.05% (95% CI: 0%-0.3%, I2 : 0%, 18 studies), and hospitalisation in 0.67% (95% CI: 0.3%-1.1%, I2 : 44%, 24 studies). No deaths occurred (95% CI: 0%-0.2% I2 : 0%, 25 studies).Endoscopic dilation is consistently effective in children and adults with EoE, resulting in improvement in 95% of patients with very low rates (<1%) of major complications.

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Published In

Alimentary pharmacology & therapeutics

DOI

EISSN

1365-2036

ISSN

0269-2813

Publication Date

July 2017

Volume

46

Issue

2

Start / End Page

96 / 105

Related Subject Headings

  • Humans
  • Gastroenterology & Hepatology
  • Esophagoscopy
  • Eosinophilic Esophagitis
  • Dilatation
  • Child
  • Adult
  • 3214 Pharmacology and pharmaceutical sciences
  • 3202 Clinical sciences
  • 1115 Pharmacology and Pharmaceutical Sciences
 

Citation

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Moawad, F. J., Molina-Infante, J., Lucendo, A. J., Cantrell, S. E., Tmanova, L., & Douglas, K. M. (2017). Systematic review with meta-analysis: endoscopic dilation is highly effective and safe in children and adults with eosinophilic oesophagitis. Alimentary Pharmacology & Therapeutics, 46(2), 96–105. https://doi.org/10.1111/apt.14123
Moawad, F. J., J. Molina-Infante, A. J. Lucendo, S. E. Cantrell, L. Tmanova, and K. M. Douglas. “Systematic review with meta-analysis: endoscopic dilation is highly effective and safe in children and adults with eosinophilic oesophagitis.Alimentary Pharmacology & Therapeutics 46, no. 2 (July 2017): 96–105. https://doi.org/10.1111/apt.14123.
Moawad FJ, Molina-Infante J, Lucendo AJ, Cantrell SE, Tmanova L, Douglas KM. Systematic review with meta-analysis: endoscopic dilation is highly effective and safe in children and adults with eosinophilic oesophagitis. Alimentary pharmacology & therapeutics. 2017 Jul;46(2):96–105.
Moawad, F. J., et al. “Systematic review with meta-analysis: endoscopic dilation is highly effective and safe in children and adults with eosinophilic oesophagitis.Alimentary Pharmacology & Therapeutics, vol. 46, no. 2, July 2017, pp. 96–105. Epmc, doi:10.1111/apt.14123.
Moawad FJ, Molina-Infante J, Lucendo AJ, Cantrell SE, Tmanova L, Douglas KM. Systematic review with meta-analysis: endoscopic dilation is highly effective and safe in children and adults with eosinophilic oesophagitis. Alimentary pharmacology & therapeutics. 2017 Jul;46(2):96–105.
Journal cover image

Published In

Alimentary pharmacology & therapeutics

DOI

EISSN

1365-2036

ISSN

0269-2813

Publication Date

July 2017

Volume

46

Issue

2

Start / End Page

96 / 105

Related Subject Headings

  • Humans
  • Gastroenterology & Hepatology
  • Esophagoscopy
  • Eosinophilic Esophagitis
  • Dilatation
  • Child
  • Adult
  • 3214 Pharmacology and pharmaceutical sciences
  • 3202 Clinical sciences
  • 1115 Pharmacology and Pharmaceutical Sciences