Predicting Symptomatic Response to Prokinetic Treatment Using Gastric Alimetry.

Area of Science:

• Gastroenterology
• Biomarker Discovery
• Neurogastroenterology

Background:

• Chronic neurogastroduodenal disorders present management challenges, often relying on empirical prokinetic therapy.
• Prokinetic efficacy is variable and associated with adverse events, limiting their use.
• Investigating novel biomarkers for personalized prokinetic selection is crucial.

Purpose of the Study:

• To evaluate body surface gastric mapping (BSGM) biomarkers for predicting prokinetic therapy response.
• To determine if Gastric Alimetry can guide prokinetic selection in patients with gastroduodenal symptoms.

Main Methods:

• Prospective recruitment of patients with chronic gastroduodenal symptoms on prokinetic agents.
• Body surface gastric mapping (BSGM) performed off-prokinetic agents with standardized meal.
• Symptom diaries and clinical response definitions used to assess outcomes.

Main Results:

• In prokinetic-naive patients, lower postprandial amplitudes predicted a positive response to prokinetic therapy (p=0.047).
• In patients already on prokinetics, lower amplitudes correlated with reduced symptom burden.
• Impaired gastric rhythm stability predicted a worse symptom burden in patients on existing prokinetics (p<0.05).

Conclusions:

• Gastric Alimetry biomarkers show potential in predicting prokinetic response for gastroduodenal disorders.
• Lower postprandial amplitudes may indicate patients likely to benefit from prokinetic therapy.
• Impaired rhythm stability suggests a poorer therapeutic response to prokinetics.