Neuromodulators and Prokinetics Combo Effective for treatment of Gastroparesis

A recent study sheds light on the limited effectiveness of traditional prokinetic therapies for gastroparesis, a condition characterized by delayed stomach emptying. The findings were published in the Clinical Gastroenterology and Hepatology.

The comprehensive research encompassed 129 patients with gastroparesis symptoms, and focused into alternative approaches such as gastroparesis diets and neuromodulators, either in isolation or combination. The study employed wireless motility capsule gastric emptying time (GET) and gastric emptying scintigraphy (GES) to assess patient responses to various therapies over a period of 6 months. Notably, the Gastroparesis Cardinal Symptom Index (GCSI) served as a key metric to measure symptom changes.

The findings underscored that prokinetics, when used as a standalone therapy, demonstrated limited efficacy in reducing symptoms, emphasizing the need for alternative or complementary treatments. In contrast, neuromodulators, administered alone, exhibited promising results by decreasing GCSI scores and alleviating individual symptoms, excluding nausea/vomiting.

This study revealed that combining prokinetics with gastroparesis diets or neuromodulators yielded more favorable outcomes. This suggests that a multi-faceted treatment approach might offer enhanced relief for patients grappling with gastroparesis symptoms.

Multivariate analyses, factoring in gastric emptying and other variables, reinforced the conclusions of study. Notably, patients with non-delayed gastric emptying responded more positively to neuromodulators as a solo therapy, emphasizing the importance of tailoring treatments to individual patient profiles.

This approach opens avenues for reevaluating therapeutic strategies for gastroparesis. While prokinetics alone may offer limited relief, combining them with complementary therapies like neuromodulators or dietary adjustments presents a more promising avenue for managing this challenging condition.

Reference:

Hasler, W. L., Lee, A. A., Moshiree, B., Surjanhata, B. C., Rao, S., Parkman, H. P., Nguyen, L. A., Sarosiek, I., Wo, J. M., Schulman, M. I., McCallum, R. W., & Kuo, B. (2023). BENEFITS OF PROKINETICS, GASTROPARESIS DIET, OR NEUROMODULATORS ALONE OR IN COMBINATION FOR SYMPTOMS OF GASTROPARESIS. In Clinical Gastroenterology and Hepatology. Elsevier BV. https://doi.org/10.1016/j.cgh.2023.10.014