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Surgical Intervention in Bariatric Patients: Excess Weight Loss in the Morbidly Obese Following Gastric Plication

Primary Purpose

Morbid Obesity

Status
Terminated
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Gastric Plication
Sponsored by
Ethicon Endo-Surgery
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Morbid Obesity focused on measuring Bariatric, Obesity

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subject is willing to give consent and comply with evaluation and treatment schedule (for female patients, this includes agreement to use a reliable (per investigator) form of birth control for the duration of the trial);
  2. 18 to 65 years of age (inclusive);
  3. Subject meets ASMBS and NIH criteria: (consensus.nih.gov)

    BMI ³ 40 kg/m2 and £ 50 kg/m2; or, BMI 35-40 kg/m2 with one or more significant co-morbid medical conditions which are generally expected to be improved, reversed, or resolved by weight loss, including:

    • Hyperlipidemia
    • Mild obstructive sleep apnea (per Investigator discretion)
    • Hypertension
    • Osteoarthritis of the hip or knee per investigational site's criteria for which the subject is being treated;
  4. ASA Class I - III;
  5. Agree to refrain from any type of weight-loss drug (prescription or OTC) or elective procedure that would affect body weight for the duration of the trial;
  6. HbA1C < 11%; and
  7. For subjects who have Type 2 diabetes, medication regimen is no more complex (2 oral medications) than oral metformin plus one oral sulfonylurea plus once daily insulin injection.

Exclusion Criteria:

  1. Documented history of drug and/or alcohol abuse within two (2) years of the Screening Visit;
  2. Previous malabsorptive or restrictive procedures performed for the treatment of obesity;
  3. Scheduled concurrent surgical procedure, with the exception of SOC liver biopsy;
  4. Women of childbearing potential who are pregnant or lactating at the time of screening or at the time of surgery;
  5. Psychiatric disorders that may affect compliance with the clinical trial, including dementia, active psychosis, severe depression requiring > 2 medications, or history of suicide attempts;
  6. Participation in any other investigational device or drug study (non-survey based trial; long-term enrollment in such studies as requiring periodic laboratory tests, etc., would be allowed) within 12 weeks of enrollment;
  7. Any condition which precludes compliance with the study, including:

    1. Inflammatory diseases of the gastrointestinal tract, including severe intractable esophagitis, gastric ulceration, duodenal ulceration, or specific inflammation such as Crohn's disease or ulcerative colitis that have been active within the past 10 years;
    2. Congenital or acquired anomalies of the GI tract, including atresias or stenosis;
    3. Severe cardiopulmonary disease or other serious organic disease that makes the subject a high-risk surgical candidate;
    4. Uncontrolled hypertension;
    5. Portal hypertension;
    6. Chronic or acute upper gastrointestinal bleeding conditions (e.g., gastric or esophageal varices);
    7. Cirrhosis;
    8. Congenital or acquired intestinal telangiectasia;
    9. Esophageal or gastric disorders including moderate severe preoperative reflux, dysmotility, or Barrett's esophagus;
    10. Presence of hiatal hernia greater than 2cm in length, with the exception of a small sliding hiatal hernia previously undiagnosed and discovered during the surgical procedure;
    11. Prior surgery of the foregut including hiatal hernia repair or prior gastric surgery;
    12. Known history of clotting disorders, hemoglobinopathies, and hemolytic disorders, including pulmonary embolus and Deep Vein Thrombosis;
    13. Pancreatitis;
    14. Gallstones (confirmed via ultrasound);
    15. Immunocompromised such as that resulting from chronic oral steroid use, chemotherapeutic agents, or immune deficiency disorders;
    16. Use of thiazolidinediones ("glitazones"), or
    17. Conditions that, in the opinion of the investigator, may jeopardize the subject's well-being and/or the soundness of this clinical study;
  8. History or presence of pre-existing autoimmune connective tissue disease; and
  9. Use of prescription or over the counter weight reduction medications or supplements within thirty days of the Screening Visit or the duration of study participation.

Sites / Locations

  • Cleveland Clinic
  • The Ohio State University Medical Center
  • OB Klinika, a.s.

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Gastric Plication Surgery

Arm Description

Outcomes

Primary Outcome Measures

Mean Percent Excess Weight Loss at 3 Years With Last Observation Carried Forward
Percent excess weight change from baseline to 3 years was calculated as (the baseline weight minus the weight at 3 years) divided by the (baseline weight minus the ideal body weight (using the upper limit of the midpoint range in the Metropolitan Tables for Life Insurance, 1983) x 100). Last observation carried forward was used for early terminated subjects. One-sided, alpha=0.025, t-test of the Percent Excess Weight Loss (EWL) at 3-years to demonstrate non-inferiority to the target weight loss value of 41.1%EWL

Secondary Outcome Measures

Full Information

First Posted
February 25, 2010
Last Updated
January 8, 2014
Sponsor
Ethicon Endo-Surgery
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1. Study Identification

Unique Protocol Identification Number
NCT01077193
Brief Title
Surgical Intervention in Bariatric Patients: Excess Weight Loss in the Morbidly Obese Following Gastric Plication
Official Title
Surgical Intervention in Bariatric Patients: Excess Weight Loss in the Morbidly Obese Following Gastric Plication
Study Type
Interventional

2. Study Status

Record Verification Date
January 2014
Overall Recruitment Status
Terminated
Why Stopped
Study was terminated due to commercial considerations and potential patient attrition at 3 years. There were no patient safety or procedure efficacy reasons.
Study Start Date
November 2009 (undefined)
Primary Completion Date
May 2012 (Actual)
Study Completion Date
May 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ethicon Endo-Surgery

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Up to 45 men and women who meet the entry criteria will undergo the gastric plication procedure. The study will assess subject excess weight loss (%EWL) following the study procedure at 1, 3, 6, 12, 18, 24, 30 and 36 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Morbid Obesity
Keywords
Bariatric, Obesity

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
44 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Gastric Plication Surgery
Arm Type
Other
Intervention Type
Procedure
Intervention Name(s)
Gastric Plication
Intervention Description
A laparoscope will be inserted to visualize the surgical area and confirm absence of injury to any surrounding organ or structure. A flexible endoscope will be passed transorally into the gastric lumen to provide insufflation. The greater curvature of the stomach is separated from the greater omentum using a harmonic scalpel starting approximately 3cm from the pylorus and ending at or near the angle of His. As needed, adhesions to the posterior surface of the stomach may be transected. At least two rows of at least five continuous stitches will be placed laparoscopically about the greater curvature of the stomach starting at or near the angle of His and ending in the antrum. An endoscope will be used to maintain a lumen during the procedure, ensuring one exists after the procedure.
Primary Outcome Measure Information:
Title
Mean Percent Excess Weight Loss at 3 Years With Last Observation Carried Forward
Description
Percent excess weight change from baseline to 3 years was calculated as (the baseline weight minus the weight at 3 years) divided by the (baseline weight minus the ideal body weight (using the upper limit of the midpoint range in the Metropolitan Tables for Life Insurance, 1983) x 100). Last observation carried forward was used for early terminated subjects. One-sided, alpha=0.025, t-test of the Percent Excess Weight Loss (EWL) at 3-years to demonstrate non-inferiority to the target weight loss value of 41.1%EWL
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is willing to give consent and comply with evaluation and treatment schedule (for female patients, this includes agreement to use a reliable (per investigator) form of birth control for the duration of the trial); 18 to 65 years of age (inclusive); Subject meets ASMBS and NIH criteria: (consensus.nih.gov) BMI ³ 40 kg/m2 and £ 50 kg/m2; or, BMI 35-40 kg/m2 with one or more significant co-morbid medical conditions which are generally expected to be improved, reversed, or resolved by weight loss, including: Hyperlipidemia Mild obstructive sleep apnea (per Investigator discretion) Hypertension Osteoarthritis of the hip or knee per investigational site's criteria for which the subject is being treated; ASA Class I - III; Agree to refrain from any type of weight-loss drug (prescription or OTC) or elective procedure that would affect body weight for the duration of the trial; HbA1C < 11%; and For subjects who have Type 2 diabetes, medication regimen is no more complex (2 oral medications) than oral metformin plus one oral sulfonylurea plus once daily insulin injection. Exclusion Criteria: Documented history of drug and/or alcohol abuse within two (2) years of the Screening Visit; Previous malabsorptive or restrictive procedures performed for the treatment of obesity; Scheduled concurrent surgical procedure, with the exception of SOC liver biopsy; Women of childbearing potential who are pregnant or lactating at the time of screening or at the time of surgery; Psychiatric disorders that may affect compliance with the clinical trial, including dementia, active psychosis, severe depression requiring > 2 medications, or history of suicide attempts; Participation in any other investigational device or drug study (non-survey based trial; long-term enrollment in such studies as requiring periodic laboratory tests, etc., would be allowed) within 12 weeks of enrollment; Any condition which precludes compliance with the study, including: Inflammatory diseases of the gastrointestinal tract, including severe intractable esophagitis, gastric ulceration, duodenal ulceration, or specific inflammation such as Crohn's disease or ulcerative colitis that have been active within the past 10 years; Congenital or acquired anomalies of the GI tract, including atresias or stenosis; Severe cardiopulmonary disease or other serious organic disease that makes the subject a high-risk surgical candidate; Uncontrolled hypertension; Portal hypertension; Chronic or acute upper gastrointestinal bleeding conditions (e.g., gastric or esophageal varices); Cirrhosis; Congenital or acquired intestinal telangiectasia; Esophageal or gastric disorders including moderate severe preoperative reflux, dysmotility, or Barrett's esophagus; Presence of hiatal hernia greater than 2cm in length, with the exception of a small sliding hiatal hernia previously undiagnosed and discovered during the surgical procedure; Prior surgery of the foregut including hiatal hernia repair or prior gastric surgery; Known history of clotting disorders, hemoglobinopathies, and hemolytic disorders, including pulmonary embolus and Deep Vein Thrombosis; Pancreatitis; Gallstones (confirmed via ultrasound); Immunocompromised such as that resulting from chronic oral steroid use, chemotherapeutic agents, or immune deficiency disorders; Use of thiazolidinediones ("glitazones"), or Conditions that, in the opinion of the investigator, may jeopardize the subject's well-being and/or the soundness of this clinical study; History or presence of pre-existing autoimmune connective tissue disease; and Use of prescription or over the counter weight reduction medications or supplements within thirty days of the Screening Visit or the duration of study participation.
Facility Information:
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
The Ohio State University Medical Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Facility Name
OB Klinika, a.s.
City
Prague
Country
Czech Republic

12. IPD Sharing Statement

Learn more about this trial

Surgical Intervention in Bariatric Patients: Excess Weight Loss in the Morbidly Obese Following Gastric Plication

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