Comparison:Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 40: Withdrawals due to adverse events, subgrouped by delivery method Study or Subgroup 1.40.1 Adapted asthma Alexander 2012 Bhardwaj 2017 Butz 2014 Konikoff 2006 Straumann 2010b Subtotal (95% CI) Total events: Heterogeneity: Tau2 = 0.72; Chi2 = 3.60, df = 2 (P = 0.17); I2 = 44% Test for overall effect: Z = 0.93 (P = 0.35) 1.40.2 Esophageal-specific Dellon 2017 Dellon 2022a Dohil 2010 Gupta 2015 Hirano 2020f Hirano 2021 Lucendo 2019 Miehlke 2016 Tytor 2021 Subtotal (95% CI) Total events: Heterogeneity: Tau2 = 0.00; Chi2 = 6.44, df = 8 (P = 0.60); I2 = 0% Test for overall effect: Z = 1.79 (P = 0.07) Total (95% CI) Total events: Heterogeneity: Tau2 = 0.00; Chi2 = 10.38, df = 11 (P = 0.50); I2 = 0% Test for overall effect: Z = 2.18 (P = 0.03) Test for subgroup differences: Chi2 = 0.15, df = 1 (P = 0.70), I2 = 0% Corticosteroids Events 2 0 5 1 0 8 2 9 7 9 0 11 8 4 1 51 59 Total 21 9 28 21 18 97 51 85 21 60 16 215 59 57 17 581 678 Placebo Events 6 0 1 4 0 11 3 5 2 3 2 11 3 2 2 33 44 Total 21 9 14 15 18 77 42 21 11 21 8 107 29 19 19 277 354 Weight 7.2% 3.7% 3.6% 14.5% 5.2% 16.2% 8.1% 10.8% 1.8% 24.4% 10.1% 6.0% 2.9% 85.5% 100.0% Risk Ratio M-H, Random, 95% CI 0.33 [0.08 , 1.47] Not estimable 2.50 [0.32 , 19.40] 0.18 [0.02 , 1.44] Not estimable 0.51 [0.12 , 2.12] 0.55 [0.10 , 3.13] 0.44 [0.17 , 1.19] 1.83 [0.46 , 7.37] 1.05 [0.31 , 3.52] 0.11 [0.01 , 1.98] 0.50 [0.22 , 1.11] 1.31 [0.38 , 4.58] 0.67 [0.13 , 3.36] 0.56 [0.06 , 5.63] 0.68 [0.44 , 1.04] 0.64 [0.43 , 0.96] Risk Ratio M-H, Random, 95% CI 0.005 0.1 1 10 200 Corticosteroids Placebo Risk of Bias A + + + + + + + + + + + + + + B + + + + ?
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 37: Withdrawals due to adverse events, sensitivity analysis, fixed-e=ect Study or Subgroup Alexander 2012 Bhardwaj 2017 Butz 2014 Dellon 2017 Dellon 2022a Dohil 2010 Gupta 2015 Hirano 2020f Hirano 2021 Konikoff 2006 Lucendo 2019 Miehlke 2016 Straumann 2010b Tytor 2021 Total (95% CI) Total events: Heterogeneity: Chi2 = 10.38, df = 11 (P = 0.50); I2 = 0% Test for overall effect: Z = 2.27 (P = 0.02) Test for subgroup differences: Not applicable Corticosteroids Events 2 0 5 2 9 7 9 0 11 1 8 4 0 1 59 Total 21 9 28 51 85 21 60 16 215 21 59 57 18 17 678 Placebo Events 6 0 1 3 5 2 3 2 11 4 3 2 0 2 44 Total 21 9 14 42 21 11 21 8 107 15 29 19 18 19 354 Weight 10.5% 2.3% 5.7% 14.0% 4.6% 7.8% 5.7% 25.7% 8.2% 7.0% 5.2% 3.3% 100.0% Risk Ratio M-H, Fixed, 95% CI 0.33 [0.08 , 1.47] Not estimable 2.50 [0.32 , 19.40] 0.55 [0.10 , 3.13] 0.44 [0.17 , 1.19] 1.83 [0.46 , 7.37] 1.05 [0.31 , 3.52] 0.11 [0.01 , 1.98] 0.50 [0.22 , 1.11] 0.18 [0.02 , 1.44] 1.31 [0.38 , 4.58] 0.67 [0.13 , 3.36] Not estimable 0.56 [0.06 , 5.63] 0.65 [0.44 , 0.94] Risk Ratio M-H, Fixed, 95% CI 0.005 0.1 1 10 200 Corticosteroids Placebo Risk of Bias A + + + + + + + + + + + + + + B + + + + + + + ? ?
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Total adverse events Thirteen studies provided data on total adverse events when corticosteroids were compared to placebo (Alexander 2012; Butz 2014; Dellon 2017; Dellon 2022a; Dohil 2010; Gupta 2015; Hirano 2020f; Hirano 2021; KonikoG 2006; Lucendo 2019; Miehlke 2016; Straumann 2010b; Tytor 2021).
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: We rated detection bias as high risk in three studies, for not blinding outcome assessors (Heine 2019; Oliva 2018; Peterson 2010), and five studies at unclear risk (Assa'ad 2011; De Rooij 2022; Straumann 2010b; Straumann 2011; Straumann 2013).
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 20: Histological improvement at study endpoint (dichotomous), subgrouped by delivery method Study or Subgroup 1.20.1 Esophageal-specific Dellon 2017 Dellon 2022a Dohil 2010 Gupta 2015 Hirano 2020f Hirano 2021 Lucendo 2019 Miehlke 2016 Subtotal (95% CI) Total events: Heterogeneity: Tau2 = 0.00; Chi2 = 6.29, df = 7 (P = 0.51); I2 = 0% Test for overall effect: Z = 7.23 (P < 0.00001) 1.20.2 Adapted asthma, allergy Alexander 2012 Butz 2014 Konikoff 2006 Straumann 2010b Subtotal (95% CI) Total events: Heterogeneity: Tau2 = 0.00; Chi2 = 1.69, df = 3 (P = 0.64); I2 = 0% Test for overall effect: Z = 5.03 (P < 0.00001) Total (95% CI) Total events: Heterogeneity: Tau2 = 0.14; Chi2 = 12.57, df = 11 (P = 0.32); I2 = 13% Test for overall effect: Z = 8.11 (P < 0.00001) Test for subgroup differences: Chi2 = 2.63, df = 1 (P = 0.10), I2 = 62.0% Corticosteroids Events 19 59 14 23 11 132 55 53 366 17 18 11 16 62 428 Total 51 85 21 60 16 215 59 57 564 21 28 21 18 88 652 Placebo Events 1 0 1 0 1 1 0 0 4 1 1 2 2 6 10 Total 42 21 11 21 8 107 29 19 258 21 14 15 18 68 326 Weight 8.1% 4.5% 8.7% 4.4% 9.0% 8.3% 4.4% 4.5% 51.9% 8.5% 8.6% 15.2% 15.8% 48.1% 100.0% Risk Ratio M-H, Random, 95% CI 15.65 [2.18 , 112.08] 30.44 [1.96 , 473.23] 7.33 [1.10 , 48.69] 16.95 [1.07 , 267.39] 5.50 [0.85 , 35.43] 65.69 [9.31 , 463.43] 55.50 [3.55 , 867.78] 36.90 [2.39 , 570.25] 18.20 [8.29 , 39.95] 17.00 [2.48 , 116.41] 9.00 [1.33 , 60.70] 3.93 [1.02 , 15.20] 8.00 [2.14 , 29.85] 7.30 [3.37 , 15.84] 11.94 [6.56 , 21.75] Risk Ratio M-H, Random, 95% CI 0.005 0.1 1 10 200 Placebo Corticosteroids Risk of Bias A + + + + + + + + + + + + B + + + + ? ?
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Withdrawals due to adverse events Fourteen studies provided data on withdrawals due to adverse events when corticosteroids were compared to placebo (Alexander 2012; Bhardwaj 2017; Butz 2014; Dellon 2017; Dellon 2022a; Dohil 2010; Gupta 2015; Hirano 2020f; Hirano 2021; KonikoG 2006; Lucendo 2019; Miehlke 2016; Straumann 2010b; Tytor 2021).
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 10: Clinical improvement at study endpoint (continuous), subgrouped by age Study or Subgroup 1.10.1 Children (18 years and younger) Dohil 2010 Subtotal (95% CI) Heterogeneity: Not applicable Test for overall effect: Z = 0.91 (P = 0.36) 1.10.2 Mixed children and adults (18 years and older) Dellon 2017 Hirano 2021 Straumann 2010b Tytor 2021 Subtotal (95% CI) Heterogeneity: Tau2 = 0.11; Chi2 = 8.80, df = 3 (P = 0.03); I2 = 66% Test for overall effect: Z = 2.63 (P = 0.009) Total (95% CI) Heterogeneity: Tau2 = 0.08; Chi2 = 8.81, df = 4 (P = 0.07); I2 = 55% Test for overall effect: Z = 2.91 (P = 0.004) Test for subgroup differences: Chi2 = 0.24, df = 1 (P = 0.62), I2 = 0% Corticosteroids Mean -1.2 14.3 -19.5 -2.22 6 SD 1.87 13 17 2.02 7.1 Total 21 21 49 198 18 16 281 302 Placebo Mean -1.85 7.5 -22.6 -4.72 1.8 SD 1.8 10.7 17.5 1.96 6.7 Total 11 11 38 89 18 17 162 173 Weight 14.0% 14.0% 24.2% 32.6% 14.4% 14.9% 86.0% 100.0% Std.
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 42: Total adverse events Study or Subgroup Alexander 2012 Butz 2014 Dellon 2017 Dellon 2022a Dohil 2010 Gupta 2015 Hirano 2020f Hirano 2021 Konikoff 2006 Lucendo 2019 Miehlke 2016 Straumann 2010b Tytor 2021 Total (95% CI) Total events: Heterogeneity: Tau2 = 0.03; Chi2 = 15.04, df = 11 (P = 0.18); I2 = 27% Test for overall effect: Z = 1.32 (P = 0.19) Test for subgroup differences: Not applicable Corticosteroids Events 7 19 20 63 3 46 12 63 1 37 15 4 0 290 Total 21 28 51 85 21 60 16 215 21 59 57 18 17 669 Placebo Events 6 9 21 13 5 10 6 28 0 12 0 1 0 111 Total 21 14 42 21 11 21 8 107 15 29 19 18 19 345 Weight 4.3% 12.1% 12.4% 16.4% 2.5% 12.0% 11.3% 15.4% 0.4% 11.8% 0.5% 0.9% 100.0% Risk Ratio M-H, Random, 95% CI 1.17 [0.47 , 2.89] 1.06 [0.66 , 1.68] 0.78 [0.50 , 1.24] 1.20 [0.84 , 1.71] 0.31 [0.09 , 1.08] 1.61 [1.01 , 2.58] 1.00 [0.61 , 1.63] 1.12 [0.77 , 1.64] 2.18 [0.09 , 50.16] 1.52 [0.94 , 2.44] 10.69 [0.67 , 170.58] 4.00 [0.49 , 32.39] Not estimable 1.14 [0.94 , 1.40] Risk Ratio M-H, Random, 95% CI 0.005 0.1 1 10 200 Corticosteroids Placebo Risk of Bias A + + + + + + + + + + + + + B + + + + + + ? ?
Sequencing:Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 40: Withdrawals due to adverse events, subgrouped by delivery method Study or Subgroup 1.40.1 Adapted asthma Alexander 2012 Bhardwaj 2017 Butz 2014 Konikoff 2006 Straumann 2010b Subtotal (95% CI) Total events: Heterogeneity: Tau2 = 0.72; Chi2 = 3.60, df = 2 (P = 0.17); I2 = 44% Test for overall effect: Z = 0.93 (P = 0.35) 1.40.2 Esophageal-specific Dellon 2017 Dellon 2022a Dohil 2010 Gupta 2015 Hirano 2020f Hirano 2021 Lucendo 2019 Miehlke 2016 Tytor 2021 Subtotal (95% CI) Total events: Heterogeneity: Tau2 = 0.00; Chi2 = 6.44, df = 8 (P = 0.60); I2 = 0% Test for overall effect: Z = 1.79 (P = 0.07) Total (95% CI) Total events: Heterogeneity: Tau2 = 0.00; Chi2 = 10.38, df = 11 (P = 0.50); I2 = 0% Test for overall effect: Z = 2.18 (P = 0.03) Test for subgroup differences: Chi2 = 0.15, df = 1 (P = 0.70), I2 = 0% Corticosteroids Events 2 0 5 1 0 8 2 9 7 9 0 11 8 4 1 51 59 Total 21 9 28 21 18 97 51 85 21 60 16 215 59 57 17 581 678 Placebo Events 6 0 1 4 0 11 3 5 2 3 2 11 3 2 2 33 44 Total 21 9 14 15 18 77 42 21 11 21 8 107 29 19 19 277 354 Weight 7.2% 3.7% 3.6% 14.5% 5.2% 16.2% 8.1% 10.8% 1.8% 24.4% 10.1% 6.0% 2.9% 85.5% 100.0% Risk Ratio M-H, Random, 95% CI 0.33 [0.08 , 1.47] Not estimable 2.50 [0.32 , 19.40] 0.18 [0.02 , 1.44] Not estimable 0.51 [0.12 , 2.12] 0.55 [0.10 , 3.13] 0.44 [0.17 , 1.19] 1.83 [0.46 , 7.37] 1.05 [0.31 , 3.52] 0.11 [0.01 , 1.98] 0.50 [0.22 , 1.11] 1.31 [0.38 , 4.58] 0.67 [0.13 , 3.36] 0.56 [0.06 , 5.63] 0.68 [0.44 , 1.04] 0.64 [0.43 , 0.96] Risk Ratio M-H, Random, 95% CI 0.005 0.1 1 10 200 Corticosteroids Placebo Risk of Bias A + + + + + + + + + + + + + + B + + + + ?
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 37: Withdrawals due to adverse events, sensitivity analysis, fixed-e=ect Study or Subgroup Alexander 2012 Bhardwaj 2017 Butz 2014 Dellon 2017 Dellon 2022a Dohil 2010 Gupta 2015 Hirano 2020f Hirano 2021 Konikoff 2006 Lucendo 2019 Miehlke 2016 Straumann 2010b Tytor 2021 Total (95% CI) Total events: Heterogeneity: Chi2 = 10.38, df = 11 (P = 0.50); I2 = 0% Test for overall effect: Z = 2.27 (P = 0.02) Test for subgroup differences: Not applicable Corticosteroids Events 2 0 5 2 9 7 9 0 11 1 8 4 0 1 59 Total 21 9 28 51 85 21 60 16 215 21 59 57 18 17 678 Placebo Events 6 0 1 3 5 2 3 2 11 4 3 2 0 2 44 Total 21 9 14 42 21 11 21 8 107 15 29 19 18 19 354 Weight 10.5% 2.3% 5.7% 14.0% 4.6% 7.8% 5.7% 25.7% 8.2% 7.0% 5.2% 3.3% 100.0% Risk Ratio M-H, Fixed, 95% CI 0.33 [0.08 , 1.47] Not estimable 2.50 [0.32 , 19.40] 0.55 [0.10 , 3.13] 0.44 [0.17 , 1.19] 1.83 [0.46 , 7.37] 1.05 [0.31 , 3.52] 0.11 [0.01 , 1.98] 0.50 [0.22 , 1.11] 0.18 [0.02 , 1.44] 1.31 [0.38 , 4.58] 0.67 [0.13 , 3.36] Not estimable 0.56 [0.06 , 5.63] 0.65 [0.44 , 0.94] Risk Ratio M-H, Fixed, 95% CI 0.005 0.1 1 10 200 Corticosteroids Placebo Risk of Bias A + + + + + + + + + + + + + + B + + + + + + + ? ?
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Total adverse events Thirteen studies provided data on total adverse events when corticosteroids were compared to placebo (Alexander 2012; Butz 2014; Dellon 2017; Dellon 2022a; Dohil 2010; Gupta 2015; Hirano 2020f; Hirano 2021; KonikoG 2006; Lucendo 2019; Miehlke 2016; Straumann 2010b; Tytor 2021).
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: We rated detection bias as high risk in three studies, for not blinding outcome assessors (Heine 2019; Oliva 2018; Peterson 2010), and five studies at unclear risk (Assa'ad 2011; De Rooij 2022; Straumann 2010b; Straumann 2011; Straumann 2013).
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 20: Histological improvement at study endpoint (dichotomous), subgrouped by delivery method Study or Subgroup 1.20.1 Esophageal-specific Dellon 2017 Dellon 2022a Dohil 2010 Gupta 2015 Hirano 2020f Hirano 2021 Lucendo 2019 Miehlke 2016 Subtotal (95% CI) Total events: Heterogeneity: Tau2 = 0.00; Chi2 = 6.29, df = 7 (P = 0.51); I2 = 0% Test for overall effect: Z = 7.23 (P < 0.00001) 1.20.2 Adapted asthma, allergy Alexander 2012 Butz 2014 Konikoff 2006 Straumann 2010b Subtotal (95% CI) Total events: Heterogeneity: Tau2 = 0.00; Chi2 = 1.69, df = 3 (P = 0.64); I2 = 0% Test for overall effect: Z = 5.03 (P < 0.00001) Total (95% CI) Total events: Heterogeneity: Tau2 = 0.14; Chi2 = 12.57, df = 11 (P = 0.32); I2 = 13% Test for overall effect: Z = 8.11 (P < 0.00001) Test for subgroup differences: Chi2 = 2.63, df = 1 (P = 0.10), I2 = 62.0% Corticosteroids Events 19 59 14 23 11 132 55 53 366 17 18 11 16 62 428 Total 51 85 21 60 16 215 59 57 564 21 28 21 18 88 652 Placebo Events 1 0 1 0 1 1 0 0 4 1 1 2 2 6 10 Total 42 21 11 21 8 107 29 19 258 21 14 15 18 68 326 Weight 8.1% 4.5% 8.7% 4.4% 9.0% 8.3% 4.4% 4.5% 51.9% 8.5% 8.6% 15.2% 15.8% 48.1% 100.0% Risk Ratio M-H, Random, 95% CI 15.65 [2.18 , 112.08] 30.44 [1.96 , 473.23] 7.33 [1.10 , 48.69] 16.95 [1.07 , 267.39] 5.50 [0.85 , 35.43] 65.69 [9.31 , 463.43] 55.50 [3.55 , 867.78] 36.90 [2.39 , 570.25] 18.20 [8.29 , 39.95] 17.00 [2.48 , 116.41] 9.00 [1.33 , 60.70] 3.93 [1.02 , 15.20] 8.00 [2.14 , 29.85] 7.30 [3.37 , 15.84] 11.94 [6.56 , 21.75] Risk Ratio M-H, Random, 95% CI 0.005 0.1 1 10 200 Placebo Corticosteroids Risk of Bias A + + + + + + + + + + + + B + + + + ? ?
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Withdrawals due to adverse events Fourteen studies provided data on withdrawals due to adverse events when corticosteroids were compared to placebo (Alexander 2012; Bhardwaj 2017; Butz 2014; Dellon 2017; Dellon 2022a; Dohil 2010; Gupta 2015; Hirano 2020f; Hirano 2021; KonikoG 2006; Lucendo 2019; Miehlke 2016; Straumann 2010b; Tytor 2021).
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 10: Clinical improvement at study endpoint (continuous), subgrouped by age Study or Subgroup 1.10.1 Children (18 years and younger) Dohil 2010 Subtotal (95% CI) Heterogeneity: Not applicable Test for overall effect: Z = 0.91 (P = 0.36) 1.10.2 Mixed children and adults (18 years and older) Dellon 2017 Hirano 2021 Straumann 2010b Tytor 2021 Subtotal (95% CI) Heterogeneity: Tau2 = 0.11; Chi2 = 8.80, df = 3 (P = 0.03); I2 = 66% Test for overall effect: Z = 2.63 (P = 0.009) Total (95% CI) Heterogeneity: Tau2 = 0.08; Chi2 = 8.81, df = 4 (P = 0.07); I2 = 55% Test for overall effect: Z = 2.91 (P = 0.004) Test for subgroup differences: Chi2 = 0.24, df = 1 (P = 0.62), I2 = 0% Corticosteroids Mean -1.2 14.3 -19.5 -2.22 6 SD 1.87 13 17 2.02 7.1 Total 21 21 49 198 18 16 281 302 Placebo Mean -1.85 7.5 -22.6 -4.72 1.8 SD 1.8 10.7 17.5 1.96 6.7 Total 11 11 38 89 18 17 162 173 Weight 14.0% 14.0% 24.2% 32.6% 14.4% 14.9% 86.0% 100.0% Std.
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 42: Total adverse events Study or Subgroup Alexander 2012 Butz 2014 Dellon 2017 Dellon 2022a Dohil 2010 Gupta 2015 Hirano 2020f Hirano 2021 Konikoff 2006 Lucendo 2019 Miehlke 2016 Straumann 2010b Tytor 2021 Total (95% CI) Total events: Heterogeneity: Tau2 = 0.03; Chi2 = 15.04, df = 11 (P = 0.18); I2 = 27% Test for overall effect: Z = 1.32 (P = 0.19) Test for subgroup differences: Not applicable Corticosteroids Events 7 19 20 63 3 46 12 63 1 37 15 4 0 290 Total 21 28 51 85 21 60 16 215 21 59 57 18 17 669 Placebo Events 6 9 21 13 5 10 6 28 0 12 0 1 0 111 Total 21 14 42 21 11 21 8 107 15 29 19 18 19 345 Weight 4.3% 12.1% 12.4% 16.4% 2.5% 12.0% 11.3% 15.4% 0.4% 11.8% 0.5% 0.9% 100.0% Risk Ratio M-H, Random, 95% CI 1.17 [0.47 , 2.89] 1.06 [0.66 , 1.68] 0.78 [0.50 , 1.24] 1.20 [0.84 , 1.71] 0.31 [0.09 , 1.08] 1.61 [1.01 , 2.58] 1.00 [0.61 , 1.63] 1.12 [0.77 , 1.64] 2.18 [0.09 , 50.16] 1.52 [0.94 , 2.44] 10.69 [0.67 , 170.58] 4.00 [0.49 , 32.39] Not estimable 1.14 [0.94 , 1.40] Risk Ratio M-H, Random, 95% CI 0.005 0.1 1 10 200 Corticosteroids Placebo Risk of Bias A + + + + + + + + + + + + + B + + + + + + ? ?
Selection:Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 40: Withdrawals due to adverse events, subgrouped by delivery method Study or Subgroup 1.40.1 Adapted asthma Alexander 2012 Bhardwaj 2017 Butz 2014 Konikoff 2006 Straumann 2010b Subtotal (95% CI) Total events: Heterogeneity: Tau2 = 0.72; Chi2 = 3.60, df = 2 (P = 0.17); I2 = 44% Test for overall effect: Z = 0.93 (P = 0.35) 1.40.2 Esophageal-specific Dellon 2017 Dellon 2022a Dohil 2010 Gupta 2015 Hirano 2020f Hirano 2021 Lucendo 2019 Miehlke 2016 Tytor 2021 Subtotal (95% CI) Total events: Heterogeneity: Tau2 = 0.00; Chi2 = 6.44, df = 8 (P = 0.60); I2 = 0% Test for overall effect: Z = 1.79 (P = 0.07) Total (95% CI) Total events: Heterogeneity: Tau2 = 0.00; Chi2 = 10.38, df = 11 (P = 0.50); I2 = 0% Test for overall effect: Z = 2.18 (P = 0.03) Test for subgroup differences: Chi2 = 0.15, df = 1 (P = 0.70), I2 = 0% Corticosteroids Events 2 0 5 1 0 8 2 9 7 9 0 11 8 4 1 51 59 Total 21 9 28 21 18 97 51 85 21 60 16 215 59 57 17 581 678 Placebo Events 6 0 1 4 0 11 3 5 2 3 2 11 3 2 2 33 44 Total 21 9 14 15 18 77 42 21 11 21 8 107 29 19 19 277 354 Weight 7.2% 3.7% 3.6% 14.5% 5.2% 16.2% 8.1% 10.8% 1.8% 24.4% 10.1% 6.0% 2.9% 85.5% 100.0% Risk Ratio M-H, Random, 95% CI 0.33 [0.08 , 1.47] Not estimable 2.50 [0.32 , 19.40] 0.18 [0.02 , 1.44] Not estimable 0.51 [0.12 , 2.12] 0.55 [0.10 , 3.13] 0.44 [0.17 , 1.19] 1.83 [0.46 , 7.37] 1.05 [0.31 , 3.52] 0.11 [0.01 , 1.98] 0.50 [0.22 , 1.11] 1.31 [0.38 , 4.58] 0.67 [0.13 , 3.36] 0.56 [0.06 , 5.63] 0.68 [0.44 , 1.04] 0.64 [0.43 , 0.96] Risk Ratio M-H, Random, 95% CI 0.005 0.1 1 10 200 Corticosteroids Placebo Risk of Bias A + + + + + + + + + + + + + + B + + + + ?
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 37: Withdrawals due to adverse events, sensitivity analysis, fixed-e=ect Study or Subgroup Alexander 2012 Bhardwaj 2017 Butz 2014 Dellon 2017 Dellon 2022a Dohil 2010 Gupta 2015 Hirano 2020f Hirano 2021 Konikoff 2006 Lucendo 2019 Miehlke 2016 Straumann 2010b Tytor 2021 Total (95% CI) Total events: Heterogeneity: Chi2 = 10.38, df = 11 (P = 0.50); I2 = 0% Test for overall effect: Z = 2.27 (P = 0.02) Test for subgroup differences: Not applicable Corticosteroids Events 2 0 5 2 9 7 9 0 11 1 8 4 0 1 59 Total 21 9 28 51 85 21 60 16 215 21 59 57 18 17 678 Placebo Events 6 0 1 3 5 2 3 2 11 4 3 2 0 2 44 Total 21 9 14 42 21 11 21 8 107 15 29 19 18 19 354 Weight 10.5% 2.3% 5.7% 14.0% 4.6% 7.8% 5.7% 25.7% 8.2% 7.0% 5.2% 3.3% 100.0% Risk Ratio M-H, Fixed, 95% CI 0.33 [0.08 , 1.47] Not estimable 2.50 [0.32 , 19.40] 0.55 [0.10 , 3.13] 0.44 [0.17 , 1.19] 1.83 [0.46 , 7.37] 1.05 [0.31 , 3.52] 0.11 [0.01 , 1.98] 0.50 [0.22 , 1.11] 0.18 [0.02 , 1.44] 1.31 [0.38 , 4.58] 0.67 [0.13 , 3.36] Not estimable 0.56 [0.06 , 5.63] 0.65 [0.44 , 0.94] Risk Ratio M-H, Fixed, 95% CI 0.005 0.1 1 10 200 Corticosteroids Placebo Risk of Bias A + + + + + + + + + + + + + + B + + + + + + + ? ?
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Total adverse events Thirteen studies provided data on total adverse events when corticosteroids were compared to placebo (Alexander 2012; Butz 2014; Dellon 2017; Dellon 2022a; Dohil 2010; Gupta 2015; Hirano 2020f; Hirano 2021; KonikoG 2006; Lucendo 2019; Miehlke 2016; Straumann 2010b; Tytor 2021).
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: We rated detection bias as high risk in three studies, for not blinding outcome assessors (Heine 2019; Oliva 2018; Peterson 2010), and five studies at unclear risk (Assa'ad 2011; De Rooij 2022; Straumann 2010b; Straumann 2011; Straumann 2013).
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 20: Histological improvement at study endpoint (dichotomous), subgrouped by delivery method Study or Subgroup 1.20.1 Esophageal-specific Dellon 2017 Dellon 2022a Dohil 2010 Gupta 2015 Hirano 2020f Hirano 2021 Lucendo 2019 Miehlke 2016 Subtotal (95% CI) Total events: Heterogeneity: Tau2 = 0.00; Chi2 = 6.29, df = 7 (P = 0.51); I2 = 0% Test for overall effect: Z = 7.23 (P < 0.00001) 1.20.2 Adapted asthma, allergy Alexander 2012 Butz 2014 Konikoff 2006 Straumann 2010b Subtotal (95% CI) Total events: Heterogeneity: Tau2 = 0.00; Chi2 = 1.69, df = 3 (P = 0.64); I2 = 0% Test for overall effect: Z = 5.03 (P < 0.00001) Total (95% CI) Total events: Heterogeneity: Tau2 = 0.14; Chi2 = 12.57, df = 11 (P = 0.32); I2 = 13% Test for overall effect: Z = 8.11 (P < 0.00001) Test for subgroup differences: Chi2 = 2.63, df = 1 (P = 0.10), I2 = 62.0% Corticosteroids Events 19 59 14 23 11 132 55 53 366 17 18 11 16 62 428 Total 51 85 21 60 16 215 59 57 564 21 28 21 18 88 652 Placebo Events 1 0 1 0 1 1 0 0 4 1 1 2 2 6 10 Total 42 21 11 21 8 107 29 19 258 21 14 15 18 68 326 Weight 8.1% 4.5% 8.7% 4.4% 9.0% 8.3% 4.4% 4.5% 51.9% 8.5% 8.6% 15.2% 15.8% 48.1% 100.0% Risk Ratio M-H, Random, 95% CI 15.65 [2.18 , 112.08] 30.44 [1.96 , 473.23] 7.33 [1.10 , 48.69] 16.95 [1.07 , 267.39] 5.50 [0.85 , 35.43] 65.69 [9.31 , 463.43] 55.50 [3.55 , 867.78] 36.90 [2.39 , 570.25] 18.20 [8.29 , 39.95] 17.00 [2.48 , 116.41] 9.00 [1.33 , 60.70] 3.93 [1.02 , 15.20] 8.00 [2.14 , 29.85] 7.30 [3.37 , 15.84] 11.94 [6.56 , 21.75] Risk Ratio M-H, Random, 95% CI 0.005 0.1 1 10 200 Placebo Corticosteroids Risk of Bias A + + + + + + + + + + + + B + + + + ? ?
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Withdrawals due to adverse events Fourteen studies provided data on withdrawals due to adverse events when corticosteroids were compared to placebo (Alexander 2012; Bhardwaj 2017; Butz 2014; Dellon 2017; Dellon 2022a; Dohil 2010; Gupta 2015; Hirano 2020f; Hirano 2021; KonikoG 2006; Lucendo 2019; Miehlke 2016; Straumann 2010b; Tytor 2021).
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 10: Clinical improvement at study endpoint (continuous), subgrouped by age Study or Subgroup 1.10.1 Children (18 years and younger) Dohil 2010 Subtotal (95% CI) Heterogeneity: Not applicable Test for overall effect: Z = 0.91 (P = 0.36) 1.10.2 Mixed children and adults (18 years and older) Dellon 2017 Hirano 2021 Straumann 2010b Tytor 2021 Subtotal (95% CI) Heterogeneity: Tau2 = 0.11; Chi2 = 8.80, df = 3 (P = 0.03); I2 = 66% Test for overall effect: Z = 2.63 (P = 0.009) Total (95% CI) Heterogeneity: Tau2 = 0.08; Chi2 = 8.81, df = 4 (P = 0.07); I2 = 55% Test for overall effect: Z = 2.91 (P = 0.004) Test for subgroup differences: Chi2 = 0.24, df = 1 (P = 0.62), I2 = 0% Corticosteroids Mean -1.2 14.3 -19.5 -2.22 6 SD 1.87 13 17 2.02 7.1 Total 21 21 49 198 18 16 281 302 Placebo Mean -1.85 7.5 -22.6 -4.72 1.8 SD 1.8 10.7 17.5 1.96 6.7 Total 11 11 38 89 18 17 162 173 Weight 14.0% 14.0% 24.2% 32.6% 14.4% 14.9% 86.0% 100.0% Std.
Article Title: Medical treatment of eosinophilic esophagitis
Article Snippet: Comparison 1: Corticosteroids vs placebo for induction of remission, Outcome 42: Total adverse events Study or Subgroup Alexander 2012 Butz 2014 Dellon 2017 Dellon 2022a Dohil 2010 Gupta 2015 Hirano 2020f Hirano 2021 Konikoff 2006 Lucendo 2019 Miehlke 2016 Straumann 2010b Tytor 2021 Total (95% CI) Total events: Heterogeneity: Tau2 = 0.03; Chi2 = 15.04, df = 11 (P = 0.18); I2 = 27% Test for overall effect: Z = 1.32 (P = 0.19) Test for subgroup differences: Not applicable Corticosteroids Events 7 19 20 63 3 46 12 63 1 37 15 4 0 290 Total 21 28 51 85 21 60 16 215 21 59 57 18 17 669 Placebo Events 6 9 21 13 5 10 6 28 0 12 0 1 0 111 Total 21 14 42 21 11 21 8 107 15 29 19 18 19 345 Weight 4.3% 12.1% 12.4% 16.4% 2.5% 12.0% 11.3% 15.4% 0.4% 11.8% 0.5% 0.9% 100.0% Risk Ratio M-H, Random, 95% CI 1.17 [0.47 , 2.89] 1.06 [0.66 , 1.68] 0.78 [0.50 , 1.24] 1.20 [0.84 , 1.71] 0.31 [0.09 , 1.08] 1.61 [1.01 , 2.58] 1.00 [0.61 , 1.63] 1.12 [0.77 , 1.64] 2.18 [0.09 , 50.16] 1.52 [0.94 , 2.44] 10.69 [0.67 , 170.58] 4.00 [0.49 , 32.39] Not estimable 1.14 [0.94 , 1.40] Risk Ratio M-H, Random, 95% CI 0.005 0.1 1 10 200 Corticosteroids Placebo Risk of Bias A + + + + + + + + + + + + + B + + + + + + ? ?
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