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POEM Outperforms Pneumatic Dilation in Randomized Achalasia Trial

Key clinical point: In patients with previously untreated achalasia, peroral endoscopic myotomy (POEM) had a high procedural success rate as compared to pneumatic dilation, but was associated with more reflux esophagitis at 2 years.

Major finding: Treatment success was achieved by 58 of 63 patients (92%) in the POEM group, compared with 34 of 63 patients (54%) in the pneumatic dilation group (P less than .001).

Study details: A randomized clinical trial including 133 adults with newly diagnosed achalasia who underwent either POEM or pneumatic dilation.

Disclosures: Funding for the study came from Fonds NutsOhra and the European Society of Gastrointestinal Endoscopy. The senior author of the study reported disclosures related to Norgine, Laborie, Medtronic, Diversatek, Nutricia, Regeneron, Celgene, Bayer, and Dr. Falk Pharma.


Ponds FA et al. JAMA. 2019;322(2):134-44.