Effect of botulinum toxin antral injection on gastric emptying and weight reduction in obese patients: a pilot study.
BACKGROUND
A potential approach to the treatment of morbid obesity is reduction of gastric emptying to achieve satiety. Botulinum toxin A (Btx-A) is a long-acting inhibitor of acetylcholine-mediated peristalsis, which is mainly responsible for gastric motility.


OBJECTIVE
To investigate whether botulinum toxin A, injected in the antrum of obese patients, delays gastric emptying.


METHODS
In a double_blind study, 18 healthy obese subjects (body mass index >30) were randomized into three groups (BTX133, BTX200 and Saline); they received Btx-A133U, Btx-A200U, or saline under endoscopic control. Gastric emptying was tested by scintigraphy before and 10 days after treatment. Body weight variations and appetite sensation were recorded after 5 weeks.


RESULTS
Fourteen patients completed the study. The botulinum toxin A-treated groups showed weight reduction, which was not statistically significant. The effects on gastric emptying were variable. Most of the botulinum toxin A treated patients reported a reduced appetite.


CONCLUSIONS
This pilot clinical trial suggests potential activity of botulinum toxin A for the manipulation of appetite.
Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy. daniele.gui@rm.unicatt.it
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D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004311:Double-Blind Method; D004435:Eating / Q000187:drug effects; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D009765:Obesity / Q000188:drug therapy*; D017060:Patient Satisfaction; D010865:Pilot Projects; D011706:Pyloric Antrum; D012527:Satiation / Q000187:drug effects; D012737:Sex Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A