Eosinophilic esophagitis occurred in nearly 3% of patients with immunoglobulin E-mediated food allergy who had undergone oral immunotherapy in a recent study.
“The onset of eosinophilic esophagitis (EoE) after oral immunotherapy (OIT) has been repeatedly described in patients with immunoglobulin E (IgE)-mediated food allergy in recent years, but the relation between the two conditions has not been fully assessed and quantified,” Alfredo J. Lucendo, MD, PhD, FEBGH, Department of Gastroenterology, Hospital General de Tomelloso, Ciudad Real, Spain, and colleagues wrote.
Alfredo J. Lucendo
Investigators conducted electronic searches of Medline, Embase and Scopus databases using keywords associated with EoE and OIT, with summary estimates determined on 118 reports. Funnel plot analysis and Egger test were used to assess publication bias.
Fifteen studies were included in the summary, including 12 on OIT, one on sublingual immunotherapy and two on subcutaneous immunotherapy. Most studies reported information from children receiving milk, egg and peanut OIT. There was a significant publication bias supporting studies that reported the development of EoE after OIT was documented.
EoE after OIT had an overall prevalence of 2.7% (95% CI, 1.7%-4%). Medium- to high-quality studies had an overall prevalence of 3.5% compared with 2.5% for studies of low quality.
“EoE often resolved after OIT discontinuation; histological remission of EoE achieved after allergen immunotherapy also was documented in two patients whose topical fluticasone treatment failed,” the researchers wrote.
“This research found the development of EoE in up to 2.7% of patients with IgE-mediated food allergy undergoing OIT,” the researchers concluded. “In contrast, there was a lack of sufficient support to consider allergen immunotherapy-based treatment for patients with EoE. Further well-designed original research is needed to confirm the results of this systematic review.”
Disclosure: The researchers report no relevant financial disclosures.