Substantial Variability in Placebo and Nocebo Responses Challenges the Validity of Network Meta- Analysis of Gastroparesis Pharmacotherapy

Summary: This study evaluated the efficacy and safety of drugs for gastroparesis through a network meta-analysis. The results showed that oral dopamine antagonists and tachykinin-1 antagonists were more effective than placebo. For individual symptoms, oral metoclopramide showed good efficacy for nausea, fullness, and bloating. However, the confidence in the evidence for most comparisons was low to moderate, indicating a need for more effective therapies for gastroparesis.

Summary: This study systematically evaluated the therapeutic benefits of multiple drugs used to treat gastroparesis symptoms. The researchers found that the therapeutic benefits are poorly understood due to lack of insight into response and adverse event rates with placebo in randomized controlled trials. They also found that placebo response rates and adverse event rates varied among different types of gastroparesis patients and trial characteristics.