- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03526263
Endoscopic Gastric Mucosal Devitalization (GMD) as a Primary Obesity Therapy (GMD)
Study Overview
Status
Intervention / Treatment
Detailed Description
Endoscopic approaches to obesity may help fulfill the unmet need of over half the US adult population that would benefit from therapy for obesity but are not receiving it. Endoscopic approaches to obesity have the potential to be more efficacious than antiobesity medications and have a lower risk-cost profile compared with bariatric surgery.
Endoscopic approaches to obesity need to be increasingly modeled on the proposed mechanisms contributing to the benefits of bariatric surgery.
The investigators seek to decipher if the gastric mucosa is an independent regulator of food intake, body weight, lipid and glucose metabolism and serum gut hormones. The investigators also wish to ascertain if selective devitalization of the gastric mucosa, without alteration in gastric volume, will improve obesity related comorbidities.
This study will be divided into 3 phases. The purpose of completing the 3 phases is to develop a minimally invasive weight loss technique that is effective, safe and ready for more rigorous assessment via a future randomized control trial.
Objectives:
Overall:
To assess the efficacy and safety of gastric mucosal devitalization for the management of obesity and its related comorbidities
Phase 1:
On an ex vivo specimen, identify the optimal color of the tissue indicating that the gastric mucosa has been sufficiently treated such that selective mucosal devitalization has occurred.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Maryland
-
Baltimore, Maryland, United States, 21202
- Johns Hopkins Bayview Medical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients scheduled to undergo vertical sleeve gastrectomy
Exclusion Criteria:
- Age under 28 or older than 60
- Insulin dependent Diabetes Mellitus
- Suspected or biopsy confirmed liver cirrhosis
- Significant ethanol consumption >21 drinks/week in men and >14 drinks/week in women
- Presence of other chronic liver disease including hepatitis B-C, autoimmune hepatitis, alpha 1 antitrypsin deficiency, Wilson's disease, and hemochromatosis
- Pregnant or breast-feeding
- Patients who already have an intragastric balloon or other gastric implant
- Patients with gastroesophageal reflux disease
- Patients with previous gastric surgeries, altered gastrointestinal anatomy such as Billroth I, Billroth II, roux-en-y gastrectomy, roux-en-y hepaticojejunostomy, or any restrictive or bypass bariatric surgery
- Patients with previous gastric embolization for obesity
- Presence of inflammatory disorder of the gastrointestinal tract
- Patients with active peptic ulcer disease
- Patients with gastroesophageal varices
- Presence of a large hiatal hernia (grade IV on Hills classification: large hiatal hernia and essentially no fold approximating the endoscope in the retroflexed view and where the lumen of the esophagus is gaping open allowing the squamous epithelium to be seen)
- Structural abnormality in the esophagus or pharynx
- Have major esophageal motility disorders as per the Chicago classification including achalasia, diffuse esophageal spasm, jackhammer esophagus, and Esophagogastric junction outflow obstruction
- Mucosal or submucosal gastric mass that is clinically suspected to be of malignant nature
- Severe clotting or bleeding disorder
- Other medical condition that does not allow for endoscopic procedure
- Severe psychiatric illness
- Unable to participate in routine medical follow-up
- On antiplatelet agents including clopidogrel, ticlopidine, prasugrel, and cangrelor. acetylsalicylic acid use will be allowed
- On anticoagulants including heparin, warfarin, dabigatran, rivaroxaban, apixaban, and edoxaban
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Gastric mucosal devitalization arm
Patients will be enrolled into the study after being scheduled to undergo vertical sleeve gastrectomy as part of routine clinical care at Johns Hopkins Bayview. The cost of the surgery will be covered by the patient's insurance and there will no extra procedural element that would add time to surgery. The intervention will occur on the excised specimen ex vivo (outside the body) and will involve devitalization of the gastric mucosa using Argon Plasma Coagulation. |
During routine laparoscopic sleeve gastrectomy surgery, once the greater curvature of the stomach is excised as per normal surgical technique, the investigators will take the specimen out and perform an ablation ex-vivo, with the intention of performing selective mucosal devitalization.
This specimen will then be transported to pathology lab for analysis.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Selective mucosal devitalization color
Time Frame: 6 months
|
Identify the optimal color of the tissue indicating that the gastric mucosa has been sufficiently treated such that selective mucosal devitalization has occurred (as determined by a pathologist examining the samples)
|
6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Submucosal injection volume
Time Frame: 6 months
|
Identify the optimal submucosal injection volume in milliliters required to facilitate selective mucosal devitalization (as determined by a pathologist examining the samples)
|
6 months
|
Energy settings
Time Frame: 6 months
|
Identify the optimal energy settings of argon plasma coagulation required to facilitate selective mucosal devitalization (as determined by a pathologist examining the samples)
|
6 months
|
Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB00089675
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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