A Study of Endoscopic Sleeve Gastroplasty for Obesity in Ulcerative Colitis

Obesity Clinical Trial

Official title:

Endoscopic Sleeve Gastroplasty (ESG) as a Treatment Option for Obesity in Ulcerative Colitis (UC) Patients Undergoing Colectomy With Ileal Pouch Anal Anastomosis (IPAA)

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05739162
• Other study ID #: 22-007643
• Status: Recruiting
• Phase: N/A
• Start date: September 20, 2023
• Est. completion date: January 2025

Study information

• Verified date: October 2023
• Source: Mayo Clinic
• Contact: ESG with IPAA Study Team
• Phone: 507-538-8238
• Email: DLRSTIPAAinfo[@]mayo.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this research is to gather information on the safety and effectiveness of Endoscopic Sleeve Gastroplasty (ESG) for weight loss in a population of obese ulcerative colitis (UC) patients undergoing colectomy with eventual Ileal Pouch Anal Anastomosis (IPAA) compared to counseling on diet and lifestyle interventions alone.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 24
• Est. completion date: January 2025
• Est. primary completion date: January 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 22 Years to 69 Years

Eligibility

Inclusion Criteria:

• BMI 30-50 kg/m2 for at least 6 months prior to ESG

• Diagnosis of UC with plans to undergo or who have already undergone colectomy as part of a plan to pursue eventual 3-stage ileal pouch anal anastomosis (IPAA)

• Willing to adhere to the diet and behavior modifications required for ESG

• Able to follow the visit schedule

• Able to provide informed consent

• If female, be either post-menopausal, surgically sterile, or agree to practice birth control during year of study and have negative serum Human Chorionic Gonadotropin (HCG) at screening/baseline

Exclusion Criteria:

• Prior gastric or bariatric surgery or other alteration to upper gastrointestinal anatomy which would preclude safe or technical performance of ESG

• Current or recent (last six months) gastric or duodenal ulceration

• Esophageal or gastric varices

• Significant motility disorder of the esophagus or stomach

• Large hiatal hernia measuring >5 cm or = 5 cm and associated with severe gastroesophageal reflux

• Severe coagulopathy, hepatic insufficiency, or cirrhosis

• Gastric mass

• Presence of any other medical condition which precludes safe performance of elective endoscopy such as poor general health and/or history of severe hepatic, cardiac, or pulmonary disease

• Serious or uncontrolled psychiatric illness which may compromise patient understanding of procedure or compliance with follow-up visits

• Unwilling to participate in an established diet and behavior modification program, with routine follow-up

• Ongoing corticosteroid use at a dose of >5 mg daily

• Daily use of anti-inflammatory agents such as non-steroidal medications, or anticoagulants without medical supervision

• Alcohol or drug addiction

• Females who are pregnant, nursing, or planning pregnancy within the next year

• Concomitant use of or unwillingness to avoid any use of weight loss medications, weight loss supplements, or weight loss herbal preparations

• Has a condition or is in a situation which in the investigator's opinion may put the subject at significant risk or may interfere significantly with the subject's participation in the study

Related Conditions & MeSH terms

• Colitis
• Colitis, Ulcerative
• Obesity
• Ulcer
• Ulcerative Colitis

Intervention

Device:
• Apollo Endoscopic Suture System
Endoscopic Sleeve Gastroplasty (ESG), and endoscopic minimally-invasive weight loss procedure, utilizing a suturing device to reduce the stomach volume by 70-80% through the creation of sleeve. This is accomplished by a series of endoscopically placed stitches through the stomach wall.

Behavioral:
• Lifestyle Intervention
Low-calorie healthy diet personalized by a dietician according to individual patients' needs and conducive to weight loss. Physical activity will be encourage and assessed.

Locations

Country	Name	City	State
United States	Mayo Clinic Minnesota	Rochester	Minnesota

Sponsors (1)

Lead Sponsor	Collaborator
Mayo Clinic

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Percent total body weight loss	Percent total body weight loss (%TBWL) calculated by the equation ((visit 3 weight in kilograms (kg) subtracted by randomization weight in kg) divided by randomization weight in kg) times 100.	6 months
Primary	Number of subjects with serious adverse events	Total number of subjects to report serious adverse event related to the ESG procedure	24 months
Secondary	Number of early peri-operative complications	Number of early (less than 30 days) peri-operative complications related to IPAA and ileostomy takedown clinical standard of care procedure	1 year following procedure
Secondary	Number of late peri-operative complications	Number of late (greater than 30 days) peri-operative complications related to IPAA and ileostomy takedown clinical standard of care procedure	1 year following procedure
Secondary	Change gastrointestinal symptom rating scale (GSRS)	ESG tolerance measured by GSRS which includes 15 items and utilizes a 7-point response scale to measure a participant's level of discomfort associated with a given GI symptom, ranging from "No discomfort at all" to "Very severe discomfort."	Week 4, Week 12, Week 24, 12 months post-ileostomy takedown
Secondary	Pouchitis disease activity index (PDAI)	Assess overall pouch function one year following ileostomy takedown using the pouchitis disease activity index (PDAI) score. The PDAI quantitates clinical symptoms and endoscopic and histological features (acute histological inflammation: crypt abscess and ulceration) on three separate six-point scores, whereby a total score higher than 7 is indicative of pouchitis.	12 months post-ileostomy takedown
Secondary	Durable weight loss	Number of subjects to achieve durable weight loss	12 months

External Links

•   Mayo Clinic Clinical Trials