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Botulinum Toxin Treatment of Oesophageal Achalasia in the Old Old and Oldest Old

A 1-Year Follow-Up Study

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Abstract

Background

Intrasphincteric injection of botulinum toxin (BTX) has become one of the most frequent therapeutic approaches for the treatment of oesophageal achalasia. This treatment seems particularly effective in elderly patients who are not candidates for more invasive procedures.

Aims

There are few or no data on BTX treatment of achalasia in the old old and oldest old. Therefore, we evaluated BTX treatment in a group of patients with achalasia in the extreme age range who were too ill or frail to undergo surgery or pneumatic dilatation.

Patients and Methods

Twelve elderly achalasic patients (age range 81–94 years, average age 86 years) with American Society of Anesthesiologists (ASA) class III–IV status were recruited for the study. After baseline clinical and instrumental evaluations, BTX 100U was injected at time 0 and 1 month later. Clinical follow-up was carried out after 3, 6 and 12 months.

Results

A significant improvement in symptom score was documented at each follow-up step. On the basis of improvements in scores, approximately 70% of patients were considered responders at the end of follow-up.

Conclusions

BTX treatment is an effective treatment in a substantial proportion of achalasic patients >80 years of age, in whom benefits are still detectable after 12 months. BTX is a therapeutic option in patients unsuitable for surgery or pneumatic dilatation.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

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Acknowledgements

No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Clinical Nutrition, University of Torino, Torino, Italy

    Luca Dughera, Edda Battaglia & Giorgio Emanuelli

  2. Gerontology and Geriatric Section, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy

    Dario Maggio

  3. Department of Emergency Surgical Unit, Ospedale Molinette, Torino, Italy

    Paola Cassolino & Pier Roberto Mioli

  4. Gastrointestinal and Hepatology Section, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy

    Antonio Morelli &  Gabrio Bassotti

Authors
  1. Luca Dughera
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  2. Edda Battaglia
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  3. Dario Maggio
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  4. Paola Cassolino
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  5. Pier Roberto Mioli
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  6. Antonio Morelli
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  7. Giorgio Emanuelli
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  8. Gabrio Bassotti
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Corresponding author

Correspondence to Gabrio Bassotti.

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Dughera, L., Battaglia, E., Maggio, D. et al. Botulinum Toxin Treatment of Oesophageal Achalasia in the Old Old and Oldest Old. Drugs Aging 22, 779–783 (2005). https://doi.org/10.2165/00002512-200522090-00006

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  • DOI: https://doi.org/10.2165/00002512-200522090-00006

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