Botulinum toxin A injected into the pyloric sphincter has been reported in small case series to treat gastroparesis.
Dr Friedenberg and colleagues from Florida studied the use of this treatment in a large number of patients with gastroparesis.
|43% had a response to botulinum toxin treatment lasting a mean of 5 months|
The researchers identified patients who underwent pyloric botulinum injection for treatment of gastroparesis.
The research team defined response as improvement or resolution of the patient's major symptom and/or two minor symptoms for 4 weeks.
The researchers reported that of 115 patients treated, 63 patients met the study criteria.
The patients included 53 women and 10 men with a mean age of 42 years, and most patients had idiopathic gastroparesis.
The researchers noted that 43% of patients experienced a symptomatic response to treatment.
The team used stepwise logistic regression, and found that male gender was associated with response to treatment.
The researchers also observed that vomiting as a major symptom was associated with a lack of response.
At 3 months follow-up, the mean duration of response for those patients responding was 5 months for women and 4 months for men.
The researchers noted that the corresponding medians were 5 or interquartile ranges of 3 to 6 for females, respectively, and medians were 4 or interquartile ranges at 3 to 4 for males, respectively.
Dr Friedenberg concludes, “Of the patients, 43% had a response to botulinum toxin treatment that lasted a mean of approximately 5 months.”
“Male gender was associated with a response to this therapy; however, durability of response was unrelated to gender.”
“Vomiting as a major symptom predicted no response.”