The following is a summary of “Double-Blind Multicenter Randomized Clinical Trial Comparing Glucagon vs Placebo in the Resolution of Alimentary Esophageal Impaction,” published in the January 2024 issue of Gastroenterology by Sanz, et al.

For a study, researchers sought to evaluate and compare the efficacy of glucagon against a placebo in the management and resolution of esophageal foreign body impaction (EFBI). Additionally, they aimed to discern any disparities in procedure duration and the occurrence of adverse events between the two interventions.

Conducted as a multicenter, randomized, double-blind trial, this study enrolled consecutive patients with confirmed alimentary EFBI. Participants were allocated randomly to one of two groups: receiving a 1 mg intravenous dose of glucagon or a placebo equivalent. Each participant underwent an upper endoscopic procedure, with subsequent evaluation of adverse events facilitated via a structured telephonic interview conducted 7 days post-intervention.

A total of 72 individuals were assigned to the glucagon cohort, while 68 were allocated to the placebo cohort. Notably, 23.6% of participants in the glucagon group failed to reveal the foreign body, a rate comparable to the 20.6% observed in the placebo group (a marginal difference of 3%, with a 95% confidence interval spanning from -10.7% to 16.8%, yielding a P-value of 0.67). In terms of procedural duration, the median time taken for foreign body extraction was consistent between the two cohorts: 4 minutes (ranging from 2 to 10 minutes) for the glucagon group and 3.5 minutes (with a range of 2 to 7 minutes) for the placebo group (a negligible difference of 0.5 minutes, with a 95% CI of -1.3 to 2.3 minutes; resulting in a P-value of 0.59). Mild pharyngeal pain emerged as the predominant adverse event, reported uniformly across both groups.

The findings underscored that glucagon doesn’t offer superior efficacy over placebo in facilitating the resolution of EFBI or in abbreviating the procedural duration required for foreign body removal.

Source: journals.lww.com/ajg/fulltext/2024/01000/double_blind_multicenter_randomized_clinical_trial.16.aspx