Botulinum toxin injections for achalasia can approximate the short-term efficacy of a single pneumatic dilation: A survival analysis approach

Botulinum toxin in the therapy of gastrointestinal motility disorders

“…Since 1995, several trials have been carried out to establish the effectiveness of Btx‐A therapy and its possible role amongst other therapeutic options. Table 2 reports the data from all 19 articles published in international journals according to the Medline database, 57 , 59–76 and Table 3 reports the data from 19 abstracts published in Gastroenterology and the American Journal of Gastroenterology between 1995 and 2002 58 ,. 77–94 Of these publications, 12 compare Btx‐A with dilation therapy (one also compares it with surgical therapy) and one studies the combination of Btx‐A and pneumatic dilation.…”

Review article: pharmacological options in achalasia

“…studies comparing single Botx injection with pneumatic LOS dilatation in achalasia. 44,47,48,54,70,76 Overall, both approaches were equally effective at 1 month, whereas pneumatic dilatation had a better outcome at 1 year (70% vs. 32%). Moreover, the long-term improvement due to balloon dilatation was associated with a sustained decrease in LOS pressure or oesophageal barium column height.…”

“…After the first encouraging report of a pilot trial in humans, the results were confirmed by the same authors in a double‐blind, placebo‐controlled study of 21 achalasic patients treated with Botx 43 , . 44 Since then, several studies have appeared in the literature; most of them, however, have been reported only in abstract form, as shown in Table 4 45 –61 . Overall, these studies in more than 450 patients showed an average decrease in LOS pressure of 32% (range 5–58%) and good clinical improvement at 1‐month follow‐up in 77% of cases (range 50–100%).…”