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Tailored Prokinetic Therapy in Gastroparesis Using Gastric Emptying and Contractility.

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Τίτλος: Tailored Prokinetic Therapy in Gastroparesis Using Gastric Emptying and Contractility.
Συγγραφείς: Ziyang JK; Department of Gastroenterology and Hepatology, Tan Tock Seng Hospital, Singapore, Singapore., Kuo B; Center for Neurointestinal Health, Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Digestive Liver Disease Division, Columbia University Medical Center, New York, New York, USA., Surjanhata B; Center for Neurointestinal Health, Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Πηγή: Neurogastroenterology and motility [Neurogastroenterol Motil] 2026 Oct; Vol. 38 (10), pp. e70463.
Τύπος έκδοσης: Clinical Trial; Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Blackwell Scientific Publications Country of Publication: England NLM ID: 9432572 Publication Model: Print Cited Medium: Internet ISSN: 1365-2982 (Electronic) Linking ISSN: 13501925 NLM ISO Abbreviation: Neurogastroenterol Motil Subsets: MEDLINE
Imprint Name(s): Original Publication: Osney Mead, Oxford, UK : Blackwell Scientific Publications, c1994-
Ιατρικοί όροι (MeSH): Gastric Emptying*/drug effects , Gastric Emptying*/physiology , Gastrointestinal Agents*/therapeutic use , Gastroparesis*/drug therapy , Gastroparesis*/physiopathology , Gastroparesis*/diagnosis , Muscle Contraction*/drug effects , Muscle Contraction*/physiology, Adult ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies
Περίληψη: Background and Aims: Physiologic biomarkers to predict prokinetic response in patients with gastroparesis-like symptoms are needed to better tailor management. This study aims to investigate phenotypes of antral high-amplitude contraction (HAC) counts relative to gastric emptying delay in patients with upper gastrointestinal (UGI) symptoms and examine response to prokinetics.
Methods: We retrospectively analyzed patients with UGI symptoms undergoing wireless motility capsule (WMC) testing. Data were collected on demographics, gastric emptying time (GET), Gastroparesis Cardinal Symptom Index (GCSI) scores, and prokinetic use. The number of HACs during a fasting period was counted. A single HAC was defined as a pressure amplitude > 65 mmHg within 20 min. Subjects were classified based on GET and HAC counts. The Wilcoxon signed-rank test compared GCSI scores at baseline and 6 months, in those with and without prokinetic use.
Results: In 135 patients, four distinct phenotypes were identified: non-delayed GET non-elevated HAC count (54.8%), non-delayed GET elevated HAC count (9.6%), delayed GET non-elevated HAC count (20.7%), and delayed GET elevated HAC count (14.8%). A total of 48.1% of all patients were on prokinetics. Those with delayed GET and elevated HAC counts showed significant improvement in GCSI scores only in subjects using prokinetics (2.95 vs. 1.98, diff -0.98, p = 0.03). In non-delayed GET, non-elevated HAC count, GCSI scores improved both with (2.61 vs. 1.68, diff -0.93, p < 0.01) and without (2.47 vs. 1.87, diff -0.61, p < 0.01) prokinetics.
Conclusion: We identified a specific phenotype of delayed GET elevated HAC count, representing patients with poor capsule exiting efficiency, which could be a biomarker for tailored prokinetic therapy.
Trial Registration: NCT02022826.
(© 2026 John Wiley & Sons Ltd.)
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Grant Information: grant MA501 Medtronic
Contributed Indexing: Keywords: capsule; gastroparesis; motility; prokinetics; wireless
Molecular Sequence: ClinicalTrials.gov NCT02022826
Substance Nomenclature: 0 (Gastrointestinal Agents)
Entry Date(s): Date Created: 20261013 Date Completed: 20261013 Latest Revision: 20261014
Update Code: 20261015
DOI: 10.1111/nmo.70463
PMID: 42864731
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1365-2982
DOI:10.1111/nmo.70463