PMID- 34974494
OWN - NLM
STAT- MEDLINE
DCOM- 20230106
LR  - 20230223
IS  - 1539-2031 (Electronic)
IS  - 0192-0790 (Linking)
VI  - 57
IP  - 2
DP  - 2023 Feb 1
TI  - Baseline Characteristics and Predictive Factors of Intravenous Immunoglobulin 
      Response in Drug and Device Refractory Gastroparesis Symptoms.
PG  - 172-177
LID - 10.1097/MCG.0000000000001655 [doi]
AB  - INTRODUCTION: Intravenous immunoglobulin (IVIG) has been shown in a small pilot 
      series to be helpful for some patients with gastroparesis that is refractory to 
      drugs, devices, and surgical therapies. Many but not all patients have serologic 
      neuromuscular markers. We hypothesize that those patients with serologic markers 
      and/or longer duration of therapy would have better responses to IVIG. MATERIALS 
      AND METHODS: We studied 47 patients with a diagnosis of gastroparesis and 
      gastroparesis-like syndrome that had all failed previous therapies including 
      available and investigational drugs, devices, and/or pyloric therapies. Patients 
      had a standardized 12-week course of IVIG, dosed as 400 mg/kg per week 
      intravenously. Symptom assessment was done with Food and Drug Administration 
      (FDA) compliant traditional patient-reported outcomes. Success to IVIG was 
      defined as 20% or greater reduction in average symptom scores from baseline to 
      the latest evaluation. RESULTS: Fourteen patients (30%) had a response, and 33 
      (70%) had no response per our definition. Patients responding had a higher 
      glutamic acid decarboxylase 65 positivity (64% vs. 30%, P =0.049, missing=3) and 
      longer duration of therapy (>12 wk/continuous: 86% vs. 48%, P =0.09). 
      CONCLUSIONS: In this moderately sized open-label series of refractory patients 
      with gastroparesis symptoms treated with IVIG, 30% of patients responded. While 
      serologic markers and extended therapies show a trend to greater response, 
      neither was statistically significant, except for glutamic acid decarboxylase 65 
      which showed a higher positivity rate in responders. We conclude that a clinical 
      trial of IVIG may be warranted in severely refractory patients with gastroparesis 
      symptoms.
CI  - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Gala, Khushboo
AU  - Gala K
AD  - Department of Internal Medicine.
FAU - Stocker, Abigail
AU  - Stocker A
AD  - Division of Gastroenterology, Department of Medicine, Hepatology & Nutrition.
FAU - Tu, Yixi
AU  - Tu Y
AD  - Division of Gastroenterology, Department of Medicine, Hepatology & Nutrition, St 
      Louis University, St Louis, MO.
FAU - Nguyen, Vincent
AU  - Nguyen V
AD  - Division of Gastroenterology, Department of Medicine, Hepatology & Nutrition.
FAU - McElmurray, Lindsay
AU  - McElmurray L
AD  - University of Louisville Health, Louisville, KY.
FAU - Cooper, Kelly
AU  - Cooper K
AD  - University of Louisville Health, Louisville, KY.
FAU - Chhabra, Garvit
AU  - Chhabra G
AD  - Department of Internal Medicine.
FAU - Mathur, Prateek
AU  - Mathur P
AD  - Department of Internal Medicine.
FAU - Vedanarayanan, Vetta
AU  - Vedanarayanan V
AD  - Department of Neurology, Dell Medical School, The University of Texas, Austin, 
      TX.
FAU - Pinkston, Christina
AU  - Pinkston C
AD  - Department of Bioinformatics and Biostatistics, School of Public Health and 
      Information Sciences, University of Louisville.
FAU - Abell, Thomas L
AU  - Abell TL
AD  - Arthur M Schoen MD Chair in Gastroenterology, Research Director Jewish Hospital 
      GI Motility Clinic, Division of Gastroenterology, Department of Medicine, 
      Hepatology, & Nutrition, University of Louisville.
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20230201
PL  - United States
TA  - J Clin Gastroenterol
JT  - Journal of clinical gastroenterology
JID - 7910017
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Pharmaceutical Preparations)
RN  - EC 4.1.1.15 (Glutamate Decarboxylase)
SB  - IM
MH  - Humans
MH  - *Gastroparesis/therapy
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - Pharmaceutical Preparations
MH  - Glutamate Decarboxylase/therapeutic use
MH  - Pylorus
MH  - Treatment Outcome
EDAT- 2022/01/03 06:00
MHDA- 2023/01/07 06:00
CRDT- 2022/01/02 20:39
PHST- 2021/02/10 00:00 [received]
PHST- 2021/11/12 00:00 [accepted]
PHST- 2022/01/03 06:00 [pubmed]
PHST- 2023/01/07 06:00 [medline]
PHST- 2022/01/02 20:39 [entrez]
AID - 00004836-202302000-00009 [pii]
AID - 10.1097/MCG.0000000000001655 [doi]
PST - epublish
SO  - J Clin Gastroenterol. 2023 Feb 1;57(2):172-177. doi: 
      10.1097/MCG.0000000000001655.