The following article is a part of conference coverage from the American College of Gastroenterology 2021 Annual Meeting , held from October 22 to 27, 2021. The team at Gastroenterology Advisor will be reporting on the latest news and research conducted by leading experts in gastroenterology. Check back for more from ACG 2021.


Topical corticosteroids were found to be more effective than placebo for achieving histologic remission and improving clinical symptoms in patients with eosinophilic esophagitis, according to research presented at the American College of Gastroenterology (ACG) 2021 Annual Meeting, held from October 22 to 27, 2021, in Las Vegas, Nevada and virtually.

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Researchers conducted a systemic review and meta-analysis of studies investigating the efficacy and safety of topical corticosteroids compared with placebo for the treatment of eosinophilic esophagitis. Studies were found by searching PubMed/MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials from inception to October 18, 2020. Random-effects models were used for statistical analysis to calculate risk ratios (RR) and confidence intervals. 

The primary outcome was histological remission, defined across studies as a >90% reduction in eosinophils. Secondary outcomes included clinical improvement and development of oral or esophageal candidiasis.

Overall, 9 randomized control trials were included, representing 483 patients. Patients receiving corticosteroids were more likely to achieve remission (RR, 12.50; 95% CI, 6.04-25.88; P <.00001; I2 = 0%) and report symptomatic clinical improvement (RR, 1.84; 95% CI, 1.02-3.32; P =.04; I2 = 64%) compared with placebo. The occurrence of oral or esophageal candidiasis was also more likely among patients receiving corticosteroids (RR, 4.31; 95% CI, 1.53-12.18; P =.006; I2= 0%).

Investigators concluded, “Future studies should investigate the effect of topical corticosteroids on endoscopic remission and other side effects.”

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Ghazaleh S, Ghazaleh D, Sayeh W, et al. Do topical corticosteroids induce histologic remission and improve clinical symptoms in eosinophilic esophagitis? a systematic review and meta-analysis of randomized controlled trials. Presented at: ACG 2021 Annual Meeting; October 22-27, 2021; Las Vegas, NV and virtual. Abstract 0289.