Botulinum Toxin A for the Treatment of Delayed Gastric Emptying
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- 1 February 2008
- journal article
- research article
- Published by Wolters Kluwer Health in The American Journal of Gastroenterology
- Vol. 103 (2), 416-423
- https://doi.org/10.1111/j.1572-0241.2007.01676.x
Abstract
Observational data suggest that intrapyloric injection of botulinum toxin A (BoTN/A) reduces symptoms and accelerates gastric emptying in idiopathic and diabetic gastroparesis. Our purpose was to determine whether botulinum toxin improves symptoms to a significantly greater extent than placebo. An additional objective was to determine whether there is an acceleration of gastric emptying after injection. A single-institution, randomized, double-blind, placebo-controlled trial* was done. Eligible patients had a Gastroparesis Cardinal Symptom Index score > or = 27 with randomization to intrapyloric botulinum toxin, 200 U (units), or saline placebo. Reassessment of symptoms and repeat gastric emptying scan at 1-month follow-up were done. Thirty-two patients were randomized to botulinum toxin (N = 16) and placebo (N = 16). At 1-month follow-up, 37.5% randomized to botulinum toxin and 56.3% randomized to placebo achieved improvement as defined by this study. There were no identifiable clinical predictors of response. The botulinum toxin group demonstrated improvement in gastric emptying; however, this was not superior to placebo. No serious adverse events were attributable to botulinum toxin. Intrapyloric injection of botulinum toxin improves gastric emptying in patients with gastroparesis, although this benefit was not superior to placebo at 1 month. Also, in comparison to placebo, symptoms do not improve significantly by 1 month after injection. Overall, we are unable to recommend botulinum toxin therapy for widespread use in the treatment of delayed gastric emptying until more data are available.Keywords
This publication has 22 references indexed in Scilit:
- Integrated Upper Gastrointestinal Response to Food IntakeGastroenterology, 2006
- Influence of intrapyloric botulinum toxin injection on gastric emptying and meal‐related symptoms in gastroparesis patientsAlimentary Pharmacology & Therapeutics, 2006
- Botulinum toxin for gastrointestinal disorders: Therapy and mechanismsNeurotoxicity Research, 2006
- Erythromycin Promotes Gastric Emptying During Acute Pain in VolunteersAnesthesia & Analgesia, 2006
- The Treatment of Diabetic Gastroparesis With Botulinum Toxin Injection of the PylorusDiabetes Care, 2004
- A multicentre randomised study of intrasphincteric botulinum toxin in patients with oesophageal achalasiaGut, 2000
- Prokinetics in Patients with Gastroparesis: A Systematic AnalysisDigestion, 1999
- Comparison of Metoclopramide and Erythromycin in the Treatment of Diabetic GastroparesisDiabetes Care, 1993
- Therapeutic Uses of Botulinum ToxinNew England Journal of Medicine, 1991
- Pyloric dysfunction in diabetics with recurrent nausea and vomitingGastroenterology, 1986