Disease duration predicts response to GPOEM for gastroparesis
WASHINGTON — Investigators found that shorter disease duration was the key predictor of response to gastric per oral endoscopic pyloromyotomy for gastroparesis, a presenter said.
In contrast, the etiology of gastroparesis was not predictive of successful treatment with GPOEM.
“The aim of this study was to evaluate the safety and efficacy of GPOEM and compare clinical outcomes between diabetic and non-diabetic cohorts, and to identify predictive factors of clinical response to the procedure,” Parit Mekaroonkamol, MD, of Emory University, said during his presentation.
In this single-center study, he and colleagues reviewed longitudinal data on 25 patients with non-diabetic gastroparesis and 15 with diabetic gastroparesis. They assessed data at baseline and at 1, 6, 12 and 18 months.
Patients showed statistically significant symptom improvements throughout the study period (P = .001), and at all time points except the 1-year mark. Further, gastric emptying scintigraphy (GES) showed gastric retention dropped by 41.7% from baseline at 2 months (P < .00001).
While etiology of gastroparesis showed no association with clinical improvement, duration of disease and reduced symptoms at 12 months were significant predictors (P = .02). Longer duration of symptoms was significantly associated with poorer response to GPOEM.
The nausea and vomiting subscale showed sustained improvement throughout the study (P < .00001), but early satiety decreased significantly only at 1 and 6 months (P = .001 and P = .002). The bloating subscale did not improve significantly.
Mekaroonkamol noted that three adverse events occurred (7.5%): a capnoperitoneum, an exacerbation of COPD and a myotomy dehiscence.
He concluded that “GPOEM is a safe and efficacious therapy for refractory gastroparesis, especially for those with predominant nausea/vomiting and short duration of disease.”
Based on these findings, he and colleagues recommended that GPOEM clinical criteria should include a gastroparesis cardinal symptom index (GCSI) score of at least 2 and a gastric retention rate higher than 20% on GES. – by Adam Leitenberger
Mekaroonkamol P, et al. Abstract 70. Presented at: Digestive Disease Week; June 2-5, 2018; Washington, D.C.
Disclosures: Mekaroonkamol reports no relevant financial disclosures. Please see the DDW faculty disclosure index for a list of all other authors’ relevant financial disclosures.