Eficácia da Fluticasona na terapia de manutenção em adultos e crianças com Esofagite Eosinofílica: revisão sistemática

Abstract

This systematic review addresses the efficacy of Fluticasone in the maintenance therapy of eosinophilic esophagitis. It is registered in PROSPERO (International prospective register of systematic reviews) under number CRD42023425964 and was reported according to the PRISMA 2020 recommendations (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The search was carried out in the electronic databases Latin American and Caribbean Health Sciences Literature database (LILACS), The Cochrane Library, PubMed (Via Medline), Web of Science, Scopus, Scielo, Sciense direct, Google Scholar and Brazilian Digital Library of Theses and Dissertations (BDTD), in addition to manual searches for references. Electronic searches were conducted until December 2024, with no restrictions on publication date or language. The descriptors “Eosinophilic Esophagitis [Mesh]” AND “Fluticasone [Mesh]” were used. The search strategies were organized according to the databases. Randomized clinical trials that evaluated the efficacy of fluticasone in maintenance therapy in patients with eosinophilic esophagitis were included. The assessment of the risk of bias was analyzed based on the recommendations of the Cochrane Collaboration using the RoB 2 tool. At the end of the search, two studies were analyzed, in which Fluticasone was shown to be effective for the long-term treatment of eosinophilic esophagitis, with good therapeutic response rates. However, there is no consensus in the literature regarding the dosage and presentation of the drug, in addition to its high cost, factors that limit its use. New studies in a randomized clinical trial model with a larger number of participants and encompassing different ethnicities are needed, evaluating the long-term histological, endoscopic and symptomatic response rates with validated metrics, in order to establish more robust evidence regarding the standardization of dose, presentation and duration of treatment undertaken.