Background: Over the last 20 years, diverse outcome measures have been used to evaluate the effectiveness of therapies for eosinophilic esophagitis (EoE). This systematic review aims to identify the readouts used in observational studies of topical corticosteroids, diet, and dilation in adult EoE patients. Methods: We searched MEDLINE and Embase for prospective and retrospective studies (cohorts/case series, randomized open-label, and case-control) evaluating the use of diets, dilation, and topical corticosteroids in adults with EoE. Two authors independently assessed the articles and extracted information about histologic, endoscopic, and patient-reported outcomes and tools used to assess treatment effects. Results: We included 69 studies that met inclusion criteria. EoE-associated endoscopic findings (assessed either as absence/presence or using Endoscopic Reference Score) were evaluated in 24/35, 11/17, and 9/17 studies of topical corticosteroids, diet, and dilation, respectively. Esophageal eosinophil density was recorded in 32/35, 17/17, and 11/17 studies of topical corticosteroids, diet, and dilation, respectively. Patient-reported outcomes were not uniformly used (only in 14, 8, and 3 studies of topical corticosteroids, diet, and dilation, respectively), and most tools were not validated for use in adults with EoE. Conclusions: Despite the lack of an agreed set of core outcomes that should be recorded and reported in studies in adult EoE patients, endoscopic EoE-associated findings and esophageal eosinophil density are commonly used to assess disease activity in observational studies. Standardization of outcomes and data supporting the use of outcomes are needed to facilitate interpretation of evidence, its synthesis, and comparisons of interventions in meta-analyses of therapeutic trials in adults with EoE.
Int Arch Allergy Immunol

中文翻译：

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成人嗜酸性粒细胞性食管炎观察性研究中使用的结果测量的系统评价

背景：在过去的 20 年中，已使用多种结局指标来评估嗜酸性粒细胞性食管炎 (EoE) 治疗的有效性。本系统评价旨在确定成人 EoE 患者局部皮质类固醇、饮食和扩张的观察性研究中使用的读数。方法：我们检索了 MEDLINE 和 Embase 的前瞻性和回顾性研究（队列/病例系列、随机开放标签和病例对照），以评估 EoE 成人饮食、扩张和局部皮质类固醇的使用。两位作者独立评估了文章并提取了有关组织学、内窥镜和患者报告结果以及用于评估治疗效果的工具的信息。结果：我们纳入了 69 项符合纳入标准的研究。EoE 相关的内窥镜检查结果（评估为不存在/存在或使用内窥镜参考评分）分别在 24/35、11/17 和 9/17 的局部皮质类固醇、饮食和扩张研究中进行了评估。分别在 32/35、17/17 和 11/17 的局部皮质类固醇、饮食和扩张研究中记录了食管嗜酸性粒细胞密度。患者报告的结果并未统一使用（仅分别在 14、8 和 3 项关于局部皮质类固醇、饮食和扩张的研究中使用），并且大多数工具未验证可用于成人 EoE。结论：尽管在成人 EoE 患者的研究中缺乏一套一致的核心结果应该记录和报告，但内窥镜 EoE 相关发现和食道嗜酸性粒细胞密度通常用于评估观察性研究中的疾病活动。需要对结果和支持结果使用的数据进行标准化，以促进对 EoE 成人治疗试验荟萃分析中证据的解释、综合和干预措施的比较。
Int Arch 过敏免疫