Outcomes and Factors Associated with Reduced Symptoms in Patients with Gastroparesis

Pankaj J. Pasricha, Katherine P. Yates, Linda Nguyen, John Clarke, Thomas L. Abell, Gianrico Farrugia, William L. Hasler, Kenneth L. Koch, William J. Snape, Richard W. McCallum, Irene Sarosiek, James Tonascia, Laura A. Miriel, Linda Lee, Frank Hamilton, Henry P. Parkman

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background & Aims Gastroparesis is a chronic clinical syndrome characterized by delayed gastric emptying. However, little is known about patient outcomes or factors associated with reduction of symptoms. Methods We studied adult patients with gastroparesis (of diabetic or idiopathic type) enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium Gastroparesis Registry, seen every 16 weeks and treated according to the standard of care with prescribed medications or other therapies at 7 tertiary care centers. Characteristics associated with reduced symptoms, based on a decrease of 1 or more in the gastroparesis cardinal symptom index (GCSI) score after 48 weeks of care, were determined from logistic regression models. Data were collected from patients for up to 4 years (median, 2.1 y). Results Of 262 patients, 28% had reductions in GCSI scores of 1 or more at 48 weeks. However, there were no significant reductions in GCSI score from weeks 48 through 192. Factors independently associated with reduced symptoms at 48 weeks included male sex, age 50 years and older, initial infectious prodrome, antidepressant use, and 4-hour gastric retention greater than 20%. Factors associated with no reduction in symptoms included overweight or obesity, a history of smoking, use of pain modulators, moderate to severe abdominal pain, a severe gastroesophageal reflex, and moderate to severe depression. Conclusions Over a median follow-up period of 2.1 years, 28% of patients treated for gastroparesis at centers of expertise had reductions in GCSI scores of 1 or greater, regardless of diabetes. These findings indicate the chronic nature of gastroparesis. We identified factors associated with reduced symptoms that might be used to guide treatment. ClinicalTrials.gov no: NCT00398801.

Original languageEnglish (US)
Pages (from-to)1762-1774e4
JournalGastroenterology
Volume149
Issue number7
DOIs
StatePublished - Dec 1 2015

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Gastroparesis
National Institute of Diabetes and Digestive and Kidney Diseases (U.S.)
Logistic Models
Gastric Emptying
Standard of Care
Tertiary Care Centers
Abdominal Pain
Antidepressive Agents
Reflex
Registries
Stomach
Obesity
Smoking
Depression

Keywords

  • Etiology
  • GpCRC
  • Improvement
  • Predictors

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Pasricha, P. J., Yates, K. P., Nguyen, L., Clarke, J., Abell, T. L., Farrugia, G., ... Parkman, H. P. (2015). Outcomes and Factors Associated with Reduced Symptoms in Patients with Gastroparesis. Gastroenterology, 149(7), 1762-1774e4. https://doi.org/10.1053/j.gastro.2015.08.008

Outcomes and Factors Associated with Reduced Symptoms in Patients with Gastroparesis. / Pasricha, Pankaj J.; Yates, Katherine P.; Nguyen, Linda; Clarke, John; Abell, Thomas L.; Farrugia, Gianrico; Hasler, William L.; Koch, Kenneth L.; Snape, William J.; McCallum, Richard W.; Sarosiek, Irene; Tonascia, James; Miriel, Laura A.; Lee, Linda; Hamilton, Frank; Parkman, Henry P.

In: Gastroenterology, Vol. 149, No. 7, 01.12.2015, p. 1762-1774e4.

Research output: Contribution to journalArticle

Pasricha, PJ, Yates, KP, Nguyen, L, Clarke, J, Abell, TL, Farrugia, G, Hasler, WL, Koch, KL, Snape, WJ, McCallum, RW, Sarosiek, I, Tonascia, J, Miriel, LA, Lee, L, Hamilton, F & Parkman, HP 2015, 'Outcomes and Factors Associated with Reduced Symptoms in Patients with Gastroparesis', Gastroenterology, vol. 149, no. 7, pp. 1762-1774e4. https://doi.org/10.1053/j.gastro.2015.08.008
Pasricha, Pankaj J. ; Yates, Katherine P. ; Nguyen, Linda ; Clarke, John ; Abell, Thomas L. ; Farrugia, Gianrico ; Hasler, William L. ; Koch, Kenneth L. ; Snape, William J. ; McCallum, Richard W. ; Sarosiek, Irene ; Tonascia, James ; Miriel, Laura A. ; Lee, Linda ; Hamilton, Frank ; Parkman, Henry P. / Outcomes and Factors Associated with Reduced Symptoms in Patients with Gastroparesis. In: Gastroenterology. 2015 ; Vol. 149, No. 7. pp. 1762-1774e4.
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abstract = "Background & Aims Gastroparesis is a chronic clinical syndrome characterized by delayed gastric emptying. However, little is known about patient outcomes or factors associated with reduction of symptoms. Methods We studied adult patients with gastroparesis (of diabetic or idiopathic type) enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium Gastroparesis Registry, seen every 16 weeks and treated according to the standard of care with prescribed medications or other therapies at 7 tertiary care centers. Characteristics associated with reduced symptoms, based on a decrease of 1 or more in the gastroparesis cardinal symptom index (GCSI) score after 48 weeks of care, were determined from logistic regression models. Data were collected from patients for up to 4 years (median, 2.1 y). Results Of 262 patients, 28{\%} had reductions in GCSI scores of 1 or more at 48 weeks. However, there were no significant reductions in GCSI score from weeks 48 through 192. Factors independently associated with reduced symptoms at 48 weeks included male sex, age 50 years and older, initial infectious prodrome, antidepressant use, and 4-hour gastric retention greater than 20{\%}. Factors associated with no reduction in symptoms included overweight or obesity, a history of smoking, use of pain modulators, moderate to severe abdominal pain, a severe gastroesophageal reflex, and moderate to severe depression. Conclusions Over a median follow-up period of 2.1 years, 28{\%} of patients treated for gastroparesis at centers of expertise had reductions in GCSI scores of 1 or greater, regardless of diabetes. These findings indicate the chronic nature of gastroparesis. We identified factors associated with reduced symptoms that might be used to guide treatment. ClinicalTrials.gov no: NCT00398801.",
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AU - Abell, Thomas L.

AU - Farrugia, Gianrico

AU - Hasler, William L.

AU - Koch, Kenneth L.

AU - Snape, William J.

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AU - Sarosiek, Irene

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KW - GpCRC

KW - Improvement

KW - Predictors

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