MagDI Canada Study

Obesity Clinical Trial

Official title:

Creation of Side-to-Side Compression Anastomosis Using the GT Metabolic MagDI System in Canada to Achieve Duodeno-Ileal Diversion in Adults With Obesity and With or Without Type 2 Diabetes Mellitus (MagDI Canada Study)

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06467955
• Other study ID #: GTM-006
• Status: Recruiting
• Phase: N/A
• Start date: May 10, 2024
• Est. completion date: August 31, 2025

Study information

• Verified date: June 2024
• Source: GT Metabolic Solutions, Inc.
• Contact: Lisa Griffin Vincent, PhD
• Phone: +1 763-200-1416
• Email: clinical[@]gtmetabolic.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The objective of the MagDI Canada study is to evaluate the performance and safety of the MagDI System in eligible participants who are indicated for a duodeno-ileal (small bowel) side-to-side anastomosis procedure for partial intestinal diversion as one example of a small bowel clinical procedure requiring a side-to-side anastomosis. The secondary objective includes initial efficacy of the duodeno-ileal diversion using the MagDI System.

Description:

The objective of the MagDI Canada study is to evaluate the performance and safety of the MagDI System in eligible participants who are indicated for a duodeno-ileal (small bowel) side-to-side anastomosis procedure for partial intestinal diversion as one example of a small bowel clinical procedure requiring a side-to-side anastomosis. The secondary objective includes initial efficacy of the duodeno-ileal diversion using the MagDI System.

The partial diversion of intestinal contents from the duodenum to the ileum via side-to-side duodeno-ileostomy is intended to facilitate weight management / loss in obese adults and improve metabolic outcomes in obese adults with type 2 diabetes mellitus (T2DM). Side-to-side anastomoses are currently created by sutures, staples, and anastomotic compression devices. The most common side-to-side anastomosis technique used today is stapling, requiring cutting of the intestines and staples remain behind in the body. Linear staplers are available in different sizes (e.g., 30mm, 45mm, 50mm, 60mm). A predicate for this side-to-side duodeno-ileostomy diversion procedure is the single-anastomosis duodeno-ileostomy (SADI) procedure.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 60
• Est. completion date: August 31, 2025
• Est. primary completion date: August 31, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

1. Between 18-65 years of age, at the time of informed consent.

2. Body Mass Index (BMI) between 30-50 kg/m2

3. Meets one of the following criteria:

1. Type 2 Diabetes Mellitus (T2DM; defined as HbA1c = 6.5%) or weight regain following previous sleeve gastrectomy (= 12 months); OR

2. Type 2 Diabetes Mellitus (T2DM; defined as HbA1c = 6.5%) or weight regain following previous endoscopic sleeve gastroplasty (= 12 months); OR

3. Type 2 Diabetes Mellitus (defined as HbA1c = 6.5%) with a Body Mass Index between 30-35 and without previous sleeve gastrectomy and no plan to perform a concurrent sleeve gastrectomy.

4. Participant agrees to refrain from any type of additional bariatric or reconstructive surgery that would affect body weight for the duration of the study.

5. Participant has been informed of the nature of the study and agrees to its provisions, complying with study required testing, medications, follow-up visits, and has provided written informed consent.

Exclusion Criteria:

1. Type 1 diabetes.

2. Use of injectable insulin.

3. Uncontrolled Type 2 Diabetes Mellitus (T2DM).

4. Investigator plans to perform a sleeve gastrectomy with the duodeno-ileal anastomosis procedure.

5. Uncontrolled hypertension, dyslipidemia or sleep apnea.

6. Prior intestinal, colonic or duodenal surgery (other than bariatric).

7. Prior surgery, trauma, prostheses, disease or genetic expression which prevent or contraindicate the procedure, including scarring and abnormal anatomy.

8. Refractory gastro-esophageal reflux disease (GERD).

9. Barrett's disease.

10. Helicobacter pylori positive and/or active ulcer disease.

11. Large hiatal hernia.

12. Inflammatory bowel or colonic diverticulitis disease.

13. Any anomaly precluding orogastric access by gastroscope and catheters, and manipulation techniques.

14. Any anomaly preventing / contraindicating endoscopic or laparoscopic access and procedures.

15. Implantable pacemaker or defibrillator.

16. Psychiatric disorder, except well-controlled depression with medication for > 6 months.

17. History of substance abuse.

18. Pregnant, lactating, or planning pregnancy during the clinical investigation. Note:

Female participants of childbearing age must agree to use safe contraception (e.g., intrauterine devices, hormonal contraceptives: contraceptive pills, implants, transdermal patches hormonal vaginal devices, injections with prolonged release).

19. Any comorbidity or current status of participant's physiological fitness that in the surgeon's or anesthesiologist's opinion represents safety concerns that make the participant medically unfit for the procedure, including any significant congenital or acquired anomalies of the GI tract at or distal to the placement of the Magnets.

20. Unhealed ulcers, bleeding lesions, tumor, or any other lesion at target Magnet deployment site.

21. Expected need for Magnetic Resonance Imaging (MRI) within the first 2 months post-procedure.

22. Any surgical or interventional procedure (including planned and/or scheduled) within the period of 30 days prior to and 30 days following the study procedure.

23. Any stroke / Transient Ischemic Attack (TIA) 6 months prior to consent.

24. Requires chronic anticoagulation therapy (except aspirin).

25. Active infections requiring antibiotic therapy, unless resolved before undergoing the study procedure.

26. Recent tobacco or nicotine product cessation 3 months prior to informed consent.

27. Known allergies to the device components (including the biofragmentable material PGLA or similar compounds) or contrast media.

28. Participants with comorbidities that are likely to result in a life expectancy of 12 months.

29. Currently participating in an investigational drug or another device study that has not reached its primary endpoint: Note: Studies requiring extended follow-up for products that were investigational, but have since become commercially available, are not considered investigational trials.

30. A positive COVID-19 test prior to the study procedure in accordance with local COVID-19 protocol.

31. Presence of other anatomic or comorbid conditions, or other medical, social or psychological conditions that, in the investigator's opinion, could limit the participant's ability to participate in the clinical investigation or to comply with follow-up requirements, or impact the scientific soundness of the clinical investigation results.

Related Conditions & MeSH terms

• Diabetes Mellitus, Type 2
• Obesity
• Type 2 Diabetes

Intervention

Device:
• Magnet System, DI Biofragmentable
Anastomoses achieved by magnetic compression.

Locations

Country	Name	City	State
Canada	McGill University	Montreal	Quebec
Canada	University of Toronto	Toronto	Ontario
Canada	Westmount Square Surgical Center	Westmount	Quebec

Sponsors (1)

Lead Sponsor	Collaborator
GT Metabolic Solutions, Inc.

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Performance of the side-to-side anastomosis for duodeno-ileal diversion using the MagDI System.	The duodeno-ileal diversion will be considered feasible if it results in successful: Placement of the Magnets (= 90% alignment of magnets) and; Passage of Magnets without surgical re-intervention; and; Creation of a patent anastomosis confirmed radiologically.; The primary endpoint will be met if the performance is confirmed in = 80% of enrolled and treated participants.	From date of study index procedure through 90 days
Primary	Safety of the MagDI System	Freedom from serious adverse events related to the study device or study device procedure requiring additional emergency surgery or re-intervention, including: All-cause mortality; Intestinal perforation and/or peritonitis; Intestinal obstruction; Life-threatening bleeding; Incidence of device malfunctions	From date of study index procedure through 360 days.