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One of the main therapeutic approaches is accelerating gastric emptying (GE) by means of prokinetic agents. Their efficacy has been demonstrated, although the association between symptom improvement and acceleration of emptying is less clear. Meta\u2010analyses have found contradictory results. Differences in applied methodology and included trials might drive these contradictions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To provide a transparent meta\u2010analysis update to elucidate the association between symptom improvement and acceleration of GE due to gastroprokinetic agents available for long\u2010term use in patients with gastroparesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Two approaches from earlier meta\u2010analyses were executed and compared. One analyzed the relative changes on active treatment versus baseline, the other compared the change from baseline on active treatment versus the change from baseline on placebo. Papers that reported sufficient numerical data for both analyses were selected. Both analyses included the same trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, both approaches yield the same positive direction of association between symptom improvement and acceleration of emptying (0.291 (\u22120.391, 0.972), <jats:italic>p<\/jats:italic>\u00a0=\u00a00.4 and 0.453 (0.123, 0.782), <jats:italic>p<\/jats:italic>\u00a0=\u00a00.007 for the active\u2010only and placebo\u2010controlled analysis respectively). The association between symptom improvement and GE acceleration for studies using optimal GE tests was either 0.028 (<jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.9) or 0.463 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.007), and for sub\u2010optimal GE tests was either 0.370 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.4) or 0.052 (<jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.9) depending on the used meta\u2010analysis methodology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The applied methodology for GE testing, and the meta\u2010analysis substantially impacts the conclusion. When considering the clinically relevant outcome of improvement from baseline, symptoms and emptying improve with prokinetics, but no correlation is found between both aspects. When the change over placebo is considered, limiting the analysis to scientifically more rigorous study approaches, changes in emptying rate and symptom improvement are positively associated.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12362","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T09:28:33Z","timestamp":1675070913000},"page":"146-162","source":"Crossref","is-referenced-by-count":24,"title":["Do prokinetic agents provide symptom relief through acceleration of gastric emptying? 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