Systematic review with meta‐analysis: the growing incidence and prevalence of eosinophilic oesophagitis in children and adults in population‐based studies

• Published in: Alimentary pharmacology & therapeutics Vol. 49; no. 9; pp. 1116 - 1125
• Main Authors: Navarro, Pilar, Arias, Ángel, Arias‐González, Laura, Laserna‐Mendieta, Emilio J., Ruiz‐Ponce, Miriam, Lucendo, Alfredo J.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.05.2019
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Children; Databases, Factual; Developed Countries - statistics & numerical data; Eosinophilic Esophagitis - epidemiology; Esophagitis; Female; Humans; Incidence; Leukocytes (eosinophilic); Male; Meta-analysis; Middle Aged; Population; Population studies; Population-based studies; Prevalence; Systematic review; Young Adult
• ISSN: 0269-2813; 1365-2036; 1365-2036
• DOI: 10.1111/apt.15231

Summary Background The frequency of eosinophilic oesophagitis (EoE) occurrence is escalating. Current diagnostic criteria recently proposed for the disease, determine that previous estimates of incidence and prevalence are outdated. Aim To gauge the current incidence and prevalence of EoE by performing a systematic review of population‐based studies. Methods Three electronic databases were searched from their inception dates to September 2018. A total of 2386 documents were screened; 29 studies reported on the prevalence and incidence of EoE in the general population. Results The pooled prevalence of EoE was 34.4 cases per 100 000 inhabitants (95% CI, 23.1‐47.5), and was higher for adults (42.2; 95% CI, 31.1‐55) than for children (34; 95% CI, 22.3‐49.2). The pooled EoE incidence rates were 6.6/100 000 person‐years (95% CI, 3‐11.7) in children and 7.7/100 000 (95% CI, 1.8‐17.8) in adults. No differences were found between North American and European studies using varied sources of data (insurance and administrative databases compared to hospital‐bases case series). Subgroup analysis according to risk of bias did not change results significantly. A steady rise in EoE incidence and prevalence rates was observed over time, comparing studies conducted under subsequent definitions for EoE. No significant publication bias was found. Conclusions In a systematic review and meta‐analysis, we found a sharp increase, higher than previous estimates, in the incidence and prevalence of EoE in population based studies. Results from studies carried out in developed countries show broad consistency and provide evidence of increasing pooled prevalence and incidence of EoE rates over time.