Intrapyloric Botulinum Toxin A Injection for Gastroparesis and Functional Upper Gastrointestinal Symptoms in Children: Mayo Clinic Experience, Review of the Literature, and Meta-analysis.
Journal
Paediatric drugs
ISSN: 1179-2019
Titre abrégé: Paediatr Drugs
Pays: Switzerland
ID NLM: 100883685
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
accepted:
23
05
2022
pubmed:
30
6
2022
medline:
8
9
2022
entrez:
29
6
2022
Statut:
ppublish
Résumé
We aimed to assess the efficacy of intrapyloric botulinum toxin A injection (IPBTI) in children with and without gastroparesis and to perform a meta-analysis and review of the literature. We retrospectively searched our electronic health records to identify children (aged < 18 years) who underwent an esophagogastroduodenoscopy with IPBTI between 2007 and 2018 for persistent upper gastrointestinal tract symptoms. We included children with and without gastroparesis and excluded children with a history of gastrointestinal surgery, gastrointestinal obstruction, or mucosal disease that could explain their symptoms. A meta-analysis including our study findings was performed. We identified 20 children (mean [standard deviation] age, 9.7 [5.8] years; 14 [70%] girls) with upper gastrointestinal symptoms who underwent IPBTI at our institution during the study period. Of the 20 children, 17 (85%) underwent gastric emptying scintigraphy, only nine (53%) of whom had gastroparesis. Response to IPBTI was reported in ten children (50%). Response to IPBTI did not differ by the presence of gastroparesis in included children (p = 0.64). Repeated IPBTI was performed in four children who had a response to the first injection; all four reported no benefit from the second IPBTI. There were no reported complications of IPBTI in our cohort. The meta-analysis indicated that 68% (95% confidence interval 59-78) of patients had a response to IPBTI, regardless of the presence of gastroparesis; 66% (95% confidence interval 53-78) of patients who had gastroparesis had a response to IPBTI. Intrapyloric botulinum toxin A injection is safe in children and can offer transient relief for patients with refractory upper gastrointestinal symptoms with and without gastroparesis.
Identifiants
pubmed: 35768647
doi: 10.1007/s40272-022-00518-x
pii: 10.1007/s40272-022-00518-x
doi:
Substances chimiques
Botulinum Toxins, Type A
EC 3.4.24.69
Types de publication
Journal Article
Meta-Analysis
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
539-545Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Références
Munchau A, Bhatia KP. Uses of botulinum toxin injection in medicine today. BMJ. 2000;320(7228):161–5.
doi: 10.1136/bmj.320.7228.161
Arbizu RA, Rodriguez L. Use of Clostridium botulinum toxin in gastrointestinal motility disorders in children. World J Gastrointest Endosc. 2015;7(5):433–7.
doi: 10.4253/wjge.v7.i5.433
Ciamarra P, Nurko S, Barksdale E, Fishman S, Di Lorenzo C. Internal anal sphincter achalasia in children: clinical characteristics and treatment with Clostridium botulinum toxin. J Pediatr Gastroenterol Nutr. 2003;37(3):315–9.
doi: 10.1097/00005176-200309000-00020
Stanghellini V, Chan FK, Hasler WL, Malagelada JR, Suzuki H, Tack J, et al. Gastroduodenal disorders. Gastroenterology. 2016;150(6):1380–92.
doi: 10.1053/j.gastro.2016.02.011
Stanghellini V, Tack J. Gastroparesis: separate entity or just a part of dyspepsia? Gut. 2014;63(12):1972–8.
doi: 10.1136/gutjnl-2013-306084
Tack J, Carbone F. Functional dyspepsia and gastroparesis. Curr Opin Gastroenterol. 2017;33(6):446–54.
doi: 10.1097/MOG.0000000000000393
James AN, Ryan JP, Parkman HP. Inhibitory effects of botulinum toxin on pyloric and antral smooth muscle. Am J Physiol Gastrointest Liver Physiol. 2003;285(2):G291–7.
doi: 10.1152/ajpgi.00296.2002
Rodriguez L, Rosen R, Manfredi M, Nurko S. Endoscopic intrapyloric injection of botulinum toxin A in the treatment of children with gastroparesis: a retrospective, open-label study. Gastrointest Endosc. 2012;75(2):302–9.
doi: 10.1016/j.gie.2011.09.042
Arts J, Holvoet L, Caenepeel P, Bisschops R, Sifrim D, Verbeke K, et al. Clinical trial: a randomized-controlled crossover study of intrapyloric injection of botulinum toxin in gastroparesis. Aliment Pharmacol Ther. 2007;26(9):1251–8.
doi: 10.1111/j.1365-2036.2007.03467.x
Friedenberg FK, Palit A, Parkman HP, Hanlon A, Nelson DB. Botulinum toxin A for the treatment of delayed gastric emptying. Am J Gastroenterol. 2008;103(2):416–23.
doi: 10.1111/j.1572-0241.2007.01676.x
Hirsch S, Nurko S, Mitchell P, Rosen R. Botulinum toxin as a treatment for feeding difficulties in young children. J Pediatr. 2020;226:228–35.
doi: 10.1016/j.jpeds.2020.06.063
Viechtbauer W. Conducting meta-analyses in R with the metafor package. J Stat Softw. 2010;36(3):1–48.
Wallace BC, Dahabreh IJ, Trikalinos TA, Lau J, Trow P, Schmid CH. Closing the gap between methodologists and end-users: R as a computational back-end. J Stat Softw. 2012;49(5):1–15.
doi: 10.18637/jss.v049.i05
Leal MC, Oliver MR, Francis P, Catto-Smith AG. Education and imaging. Gastrointestinal: botulinum toxin effective in refractory gastroparesis in paediatric practice. J Gastroenterol Hepatol. 2015;30(2):232.
Woodward MN, Spicer RD. Intrapyloric botulinum toxin injection improves gastric emptying. J Pediatr Gastroenterol Nutr. 2003;37(2):201–2.
doi: 10.1097/00005176-200308000-00023
Mercier C, Ley D, Aumar M, Lemale J, Fabre A, Colinet S, et al. Comparison of symptom control in pediatric gastroparesis using endoscopic pyloric botulinum toxin injection and dilatation. J Pediatr Gastroenterol Nutr. 2021;73(3):314–8.
doi: 10.1097/MPG.0000000000003195
Coleski R, Anderson MA, Hasler WL. Factors associated with symptom response to pyloric injection of botulinum toxin in a large series of gastroparesis patients. Dig Dis Sci. 2009;54(12):2634–42.
doi: 10.1007/s10620-008-0660-9
Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology. 2006;130(5):1527–37.
doi: 10.1053/j.gastro.2005.08.063
Chitkara DK, Camilleri M, Zinsmeister AR, Burton D, El-Youssef M, Freese D, et al. Gastric sensory and motor dysfunction in adolescents with functional dyspepsia. J Pediatr. 2005;146(4):500–5.
doi: 10.1016/j.jpeds.2004.11.031
Kovacic K, Elfar W, Rosen JM, Yacob D, Raynor J, Mostamand S, et al. Update on pediatric gastroparesis: a review of the published literature and recommendations for future research. Neurogastroenterol Motil. 2020;32(3): e13780.
doi: 10.1111/nmo.13780
Knatten CK, Avitsland TL, Medhus AW, Fjeld JG, Pripp AH, Emblem R, et al. Gastric emptying in children with gastroesophageal reflux and in healthy children. J Pediatr Surg. 2013;48(9):1856–61.
doi: 10.1016/j.jpedsurg.2013.03.076
Ziessman HA, Bonta DV, Goetze S, Ravich WJ. Experience with a simplified, standardized 4-hour gastric-emptying protocol. J Nucl Med. 2007;48(4):568–72.
doi: 10.2967/jnumed.106.036616
Abell TL, Camilleri M, Donohoe K, Hasler WL, Lin HC, Maurer AH, et al. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. Am J Gastroenterol. 2008;103(3):753–63.
doi: 10.1111/j.1572-0241.2007.01636.x
McCallum RW, Grill BB, Lange R, Planky M, Glass EE, Greenfeld DG. Definition of a gastric emptying abnormality in patients with anorexia nervosa. Dig Dis Sci. 1985;30(8):713–22.
doi: 10.1007/BF01320484
Sutcliffe JR, King SK, Hutson JM, Cook DJ, Southwell BR. Gastrointestinal transit in children with chronic idiopathic constipation. Pediatr Surg Int. 2009;25(6):465–72.
doi: 10.1007/s00383-009-2374-2
Santoro A, Delussi M, Leone M, Miscio AM, De Rocco L, Leo G, et al. Effects of botulinum toxin on migraine attack features in chronic migraine: a six-month open-label observation study through electronic diary smartphone application. Toxins (Basel). 2019;11:668.
doi: 10.3390/toxins11110668
Escher CM, Paracka L, Dressler D, Kollewe K. Botulinum toxin in the management of chronic migraine: clinical evidence and experience. Ther Adv Neurol Disord. 2017;10(2):127–35.
doi: 10.1177/1756285616677005