Obesity Clinical Trial
— HAPCETOfficial title:
Hybrid Argon Plasma Coagulation and Endoscopic Sleeve Gastroplasty Trial (HAPCET): A Single-center Randomized Controlled Trial
Verified date | February 2024 |
Source | Mayo Clinic |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This study is being done to evaluate the safety and effectiveness of combined Hybrid Argon Plasma Coagulation (HAPC) and Endoscopic Sleeve Gastroplasty (ESG) for weight loss and improvement in obesity-related co-morbidities compared to ESG alone in participants with a BMI ≥ 30 and ≤40 kg/m² who have failed to achieve and maintain weight loss with a non-surgical program.
Status | Active, not recruiting |
Enrollment | 24 |
Est. completion date | January 2025 |
Est. primary completion date | July 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 21 Years to 65 Years |
Eligibility | Inclusion Criteria: - BMI = 30 and =40 kg/m² - Willingness to comply with the substantial lifelong dietary restrictions required by the procedure. - History of failure with non-surgical weight-loss methods. - Willingness to follow protocol requirements, including signed informed consent, routine follow-up schedule, completing laboratory tests, and completing diet counseling. - Residing within a reasonable distance from the investigator's office and able to travel to the investigator to complete all routine follow-up visits. - Ability to give informed consent. - Women of childbearing potential (i.e., not post-menopausal or surgically sterilized) must agree to use adequate birth control methods. Exclusion Criteria: - History of foregut or gastrointestinal (GI) surgery (except uncomplicated cholecystectomy or appendectomy). - Prior gastrointestinal surgery with sequelae, i.e. obstruction, and/or adhesive peritonitis or known abdominal adhesions. - Prior open or laparoscopic bariatric surgery. - Prior surgery of any kind on the esophagus, stomach, or any type of hiatal hernia surgery. - Any inflammatory disease of the gastrointestinal tract including severe (LA Grade C or D) esophagitis, Barrett's esophagus, gastric ulceration, duodenal ulceration, cancer, or specific inflammatory disease such as Crohn's disease or celiac disease. - Potential upper gastrointestinal bleeding conditions such as esophageal or gastric varices, congenital or acquired intestinal telangiectasis, or other congenital anomalies of the gastrointestinal tract such as atresias or stenoses. - Gastrointestinal stromal tumors, history of premalignant gastric lesions (intestinal metaplasia), history of familial and nan-familial adenomatous syndromes. - A gastric mass or gastric polyps > 1 cm in size. - A hiatal hernia > 4cm of axial displacement of the z-line above the diaphragm or severe or intractable gastro-esophageal reflux symptoms. - A structural abnormality in the esophagus or pharynx such as a stricture or diverticulum that could impede passage of the endoscope. - Achalasia or any other severe esophageal motility disorder - Severe coagulopathy. - Insulin-dependent diabetes (either Type 1 or Type 2) or a significant likelihood of requiring insulin treatment in the following 12 months or a HgbA1C=9. - Subjects with any serious health condition unrelated to their weight that would increase the risk of endoscopy. - Chronic abdominal pain. - Motility disorders of the GI tract such as gross esophageal motility disorders, gastroparesis or intractable constipation. - Hepatic insufficiency or cirrhosis. - Use of an intragastric device prior to this study due to the increased thickness of the stomach wall preventing effective suturing. - Active psychological issues preventing participation in a life-style modification program as determined by a psychologist. - Patients unwilling to participate in an established medically supervised diet and behavior modification program, with routine medical follow-up. - Patients receiving daily prescribed treatment with high dose aspirin (> 81mg daily), anti-inflammatory agents, anticoagulants, or other gastric irritants. - Patients who are unable or unwilling to take prescribed proton pump inhibitor medication. - Patients who are pregnant or breast-feeding. - Patients currently taking weight-loss medications or other therapies for weight loss within the prior 6 months. - Subjects with severe cardiopulmonary disease or other serious organic disease which might include known history of coronary artery disease, myocardial infarction within the past 6 months, poorly controlled hypertension, required use of NSAIDs. - Subjects taking medications on specified hourly intervals that may be affected by changes to gastric emptying, such as anti-seizure or anti-arrhythmic medications. - Subjects who are taking corticosteroids, immunosuppressants, and narcotics. - Symptomatic congestive heart failure, cardiac arrhythmia, or unstable coronary artery disease. - Pre-existing respiratory disease such as moderate or severe chronic obstructive pulmonary disease (COPD) requiring steroids, pneumonia, or cancer. - Diagnosis of autoimmune connective tissue disorder (e.g. Systemic lupus erythematosus, scleroderma) or immunocompromised. - Specific diagnosed genetic disorder such as Prader Willi syndrome. - Eating disorders including night eating syndrome (NES), bulimia, binge eating disorder, or compulsive overeating. - Known history of endocrine disorders affecting weight such as uncontrolled hypothyroidism. - At the discretion of the PI for subject safety - If minority inclusion population target of 10% has not been reached by the 90% enrollment mark (example 21 of 24 subjects), the remaining enrollments will be reserved for minority subjects (example 3 of 24 subjects). |
Country | Name | City | State |
---|---|---|---|
United States | Mayo Clinic Rochester | Rochester | Minnesota |
Lead Sponsor | Collaborator |
---|---|
Mayo Clinic | Erbe Elektromedizin GmbH |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Durability | The primary outcomes are durability of plications and endoscopic sutures on repeat endoscopy at 6 months, in the two randomized arms. | 6 months | |
Secondary | %TBWL | Compared between treatment arms using ANCOVA with adjustment for the same variables specified in the primary analysis | 6 month | |
Secondary | %EWL | Compared between treatment arms using ANCOVA with adjustment for the same variables specified in the primary analysis | 6 and 12 month | |
Secondary | Blood Pressure | Compared between treatment arms using ANCOVA with adjustment for the same variables specified in the primary analysis | 6 month | |
Secondary | HbA1c | Compared between treatment arms using ANCOVA with adjustment for the same variables specified in the primary analysis | 6 month | |
Secondary | Questionnaire: SF-36 | Compared between treatment arms using ANCOVA with adjustment for the same variables specified in the primary analysis | 6 month | |
Secondary | Questionnaire: IWQOL | Compared between treatment arms using ANCOVA with adjustment for the same variables specified in the primary analysis | 6 month | |
Secondary | Questionnaire: PHQ-9 | Compared between treatment arms using ANCOVA with adjustment for the same variables specified in the primary analysis | 6 month | |
Secondary | Questionnaire: Eating Behavior | Compared between treatment arms using ANCOVA with adjustment for the same variables specified in the primary analysis | 6 month | |
Secondary | Binary Outcome: =25% reduction in %EWL | Compared between treatment arms by Pearson Chi-square test. | 6 month | |
Secondary | Binary Outcome: Incidence of esophagitis | Compared between treatment arms by Pearson Chi-square test. | 6 month |
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