Predicting symptomatic response to prokinetic treatment using Gastric Alimetry

Area of Science:

• Gastroenterology
• Physiology
• Biomarker Discovery

Background:

• Chronic neurogastroduodenal disorders present management challenges.
• Prokinetic therapy is used but has variable responses and adverse events.
• Patient selection for prokinetics is often empirical.

Purpose of the Study:

• To investigate if body surface gastric mapping (BSGM) biomarkers can inform patient selection for prokinetic therapy.
• To assess the predictive value of Gastric Alimetry biomarkers for prokinetic response.

Main Methods:

• Prospective recruitment of patients with chronic gastroduodenal symptoms on oral prokinetics.
• Body surface gastric mapping (BSGM) performed off prokinetic medication.
• Symptom diaries used for follow-up; responders defined by clinically important difference.

Main Results:

• Prokinetic prescribing was independent of BSGM metrics.
• In patients on existing prokinetics, lower amplitudes predicted reduced symptom burden, and low rhythm stability predicted worse burden.
• In prokinetic-naive patients, lower postprandial amplitude predicted prokinetic responders (p=0.047).

Conclusions:

• Gastric Alimetry biomarkers show potential for predicting prokinetic response.
• Lower postprandial amplitudes may predict therapeutic benefit.
• Impaired gastric rhythm stability might indicate a poorer therapeutic response.