BACKGROUND & AIMS: Proton pump inhibitor (PPI) therapy results in clinical and histological remission in approximately 50% of eosinophilic esophagitis (EoE) patients. We aimed to systematically update this topic due to cumulative data from pediatric/adult populations in wider geographical settings. METHODS: A search in MEDLINE, EMBASE, and SCOPUS databases was performed. Primary outcomes were clinical response and histological remission (<
15 eos/HPF). Subgroup analyses included age group, PPI drug and dosage, study design, data origin, and risk of bias. Data were pooled using random-effects models. RESULTS: Seventy-three studies comprising 7304 patients were included. PPI therapy led to clinical response in 65% (95%CI, 57.2-72.4
I CONCLUSIONS: PPI therapy induces clinic-histological remission in almost half of pediatric and adult EoE patients. Response to PPIs is significantly higher in Japan. Sustained remission is common on tapering PPI doses.