ULTIMATE Study for Weight Loss (ULTIMATE)
Primary Purpose
Obesity
Status
Completed
Phase
Not Applicable
Locations
Spain
Study Type
Interventional
Intervention
g-Cath Suture Anchor Delivery Catheter
Sponsored by

About this trial
This is an interventional treatment trial for Obesity focused on measuring POSE
Eligibility Criteria
Inclusion Criteria:
- Has a BMI of >30 and <40
- Male or female ≥21 yrs. of age and < 60 yrs. of age at time of enrollment
- Patient has had no significant weight change (+/- 5% of total body weight) in last 6 months but has been able to lose significant weight in the past with diet and exercise.
- Is a reasonable candidate for general anesthesia
- Agrees not to have any additional weight loss interventional procedures or liposuction for at least 18 months following study enrollment and agrees not to take any prescription or over the counter weight loss medications for at least 1 year.
- Physically and mentally able to comply with the visit schedule, ancillary testing, and behavior modification (diet and exercise) required for the study and agrees to study commitment requirements
- Had successful completion of the pre-screening, nutritional and educational programs and psychological assessment supporting that the subject is an appropriate bariatric surgical candidate
Exclusion Criteria:
- History of (or intra-operative evidence of) bariatric, gastric or esophageal surgery
- Esophageal stricture or other anatomy and/or condition that could preclude passage of endolumenal instruments
- Moderate to severe Gastro-esophageal reflux disease (GERD)
- Known hiatal hernia >3cm by history or as determined by UGI exam or endoscopy
- Known GI motility disorder or pancreatic insufficiency/disease
- Intra-operative Exclusion: Active peptic ulcer or hiatal hernia >3cm
- Pregnancy.
- Present Corticosteroid Use
- History of inflammatory disease of GI tract
- Severe coagulopathies, hepatic insufficiency or cirrhosis
- History or present use of insulin or insulin derivatives for treatment of diabetes
- Had Type II Diabetes Mellitus (as defined by HgbA1c >6.0) for greater than 2 years at the time of enrollment
- Uncontrolled Type II DM (HgbA1c >7.0 at screening)
- Patient has quit smoking within last 6 months at time of enrollment or plans to quit smoking in the next year
- Patient has a history of drug or alcohol abuse or actively abusing either
- Patient is presently being treated with medication for depression, psychosis, or other mood or eating disorder
- Non-ambulatory or has significant impairment of mobility
- Works for, or is first degree relative of investigator, study institution, or support staff involved in the study.
- Known hormonal or genetic cause for obesity
- Participating in another clinical study
- Patient is on medications known to impact GI motility or gut hormones that cannot be discontinued prior to nuclear testing
- Have work hours, family obligations or transportation issues that could interfere with patient returning for all scheduled evaluations, tests and nutritional counseling.
- Lives >60 kilometers from investigator site.
- Patient is not able to provide written informed consent
Sites / Locations
- Centro Medico Teknon
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Ultimate Anchor
Arm Description
Use of the g-Cath Suture Anchor Delivery Catheter and accessories in placing the ultimate number of anchors for weight loss.
Outcomes
Primary Outcome Measures
Weight Loss
Weight loss will be monitored and recorded on a monthly basis for up to 18 months post POSE with the proportion of subjects achieving ≥25% excess weight loss (EWL) at 12 months (Met Life criteria)being the primary efficacy endpoint
Secondary Outcome Measures
Gastric emptying
This test consists of determining if there is a Clinically significant change in the duration of a radioactive marker (which is non-absorbable, and free of any food components) in a stomach pre and post POSE. In order to carry out this test, a piece of food is marked with a radioactive isotope and, by using an abdominal gamma camera; detections of radioactivity are made in the stomach during the postprandial period.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01771276
Brief Title
ULTIMATE Study for Weight Loss
Acronym
ULTIMATE
Official Title
Evaluating Impact of ULTIMATE Number of G-CATH EZ- Suture Anchors Placed Endoscopically on Motility, Metabolism, Satiety, and Weight Utilizing the Incisionless Operating Platform for the Treatment of Primary Obesity
Study Type
Interventional
2. Study Status
Record Verification Date
April 2015
Overall Recruitment Status
Completed
Study Start Date
June 2012 (undefined)
Primary Completion Date
December 2013 (Actual)
Study Completion Date
December 2013 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
USGI Medical
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to help find out more about how the Primary Obesity Surgery Endoluminal (POSE) procedure makes patients feel less hungry and fuller faster, leading to weight loss. In this study, USGI Medical wants to see if stomach emptying and gastro-intestinal hormone levels change after a POSE procedure with an increased (as compared to typical) number of anchors placed.
Detailed Description
This study will use the USGI Medical Incisionless Operating Platform (IOP) to determine the affects of placing more Suture Anchors per patient (as compared to the current practice) in Primary Obesity Surgery Endoluminal(POSE). USGI wants to see if placing more anchors (particularly in the distal body/antrum region) significantly impacts primary weight loss, satiety, and metabolic outcomes.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Obesity
Keywords
POSE
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Ultimate Anchor
Arm Type
Experimental
Arm Description
Use of the g-Cath Suture Anchor Delivery Catheter and accessories in placing the ultimate number of anchors for weight loss.
Intervention Type
Device
Intervention Name(s)
g-Cath Suture Anchor Delivery Catheter
Intervention Description
Evaluate changes in emptying, hormones, satiety and weight loss with use of the g-Cath Suture Anchor Delivery Catheter in maximizing g-Cath Suture Anchor placement to as high as 25 anchors.
Primary Outcome Measure Information:
Title
Weight Loss
Description
Weight loss will be monitored and recorded on a monthly basis for up to 18 months post POSE with the proportion of subjects achieving ≥25% excess weight loss (EWL) at 12 months (Met Life criteria)being the primary efficacy endpoint
Time Frame
18 months
Secondary Outcome Measure Information:
Title
Gastric emptying
Description
This test consists of determining if there is a Clinically significant change in the duration of a radioactive marker (which is non-absorbable, and free of any food components) in a stomach pre and post POSE. In order to carry out this test, a piece of food is marked with a radioactive isotope and, by using an abdominal gamma camera; detections of radioactivity are made in the stomach during the postprandial period.
Time Frame
Immediately Pre-procedure, & 2 & 6 months post procedure
Other Pre-specified Outcome Measures:
Title
Satiety
Description
This test consists of determining if there is a Clinically significant change in Satiety pre and post POSE. The subjects ingest a nutritional drink (Ensure) at a constant rate of 30 mL per minute, constantly filling the glass with a perfusion pump (Gemini PC-2, IMED, San Diego, CA). (The subjects are not conscious of the volume being ingested.) The subjects are instructed to maintain consumption at the fill rate. Participants take note of their sensation of satiety with a graphical classification scale, which combines verbal descriptors on a scale of 0 to 5 (0 = no symptoms, 1 = first sensation of fullness [threshold]; 2 = light, 3 = moderate, 4 = severe, and 5 = maximum fullness or unbearable). The participants are told to stop taking the food product when a score of 5 is obtained. The maximum consumption of volume of the nutritional drink is recorded.
Time Frame
Immediately Pre-procedure, & 2 & 6 months post procedure
Title
Peptide Measurements
Description
This test consists of determining if there is a Clinically significant change in peptides pre and post procedure.
Samples to be collected when fasting and 30, 60, 90, and 120 minutes after a standard meal (A meal consisting of 400 calories is used), The meal must be consumed within 10 minutes.
Samples to be collected by ELISA are: C-peptide, serum insulin, glucose, PYY, GLP-1 (active), leptin, and GIP. Total ghrelin level to be analyzed by RIA.
Time Frame
Immediately Pre-procedure & 2 Months post procedure
10. Eligibility
Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Has a BMI of >30 and <40
Male or female ≥21 yrs. of age and < 60 yrs. of age at time of enrollment
Patient has had no significant weight change (+/- 5% of total body weight) in last 6 months but has been able to lose significant weight in the past with diet and exercise.
Is a reasonable candidate for general anesthesia
Agrees not to have any additional weight loss interventional procedures or liposuction for at least 18 months following study enrollment and agrees not to take any prescription or over the counter weight loss medications for at least 1 year.
Physically and mentally able to comply with the visit schedule, ancillary testing, and behavior modification (diet and exercise) required for the study and agrees to study commitment requirements
Had successful completion of the pre-screening, nutritional and educational programs and psychological assessment supporting that the subject is an appropriate bariatric surgical candidate
Exclusion Criteria:
History of (or intra-operative evidence of) bariatric, gastric or esophageal surgery
Esophageal stricture or other anatomy and/or condition that could preclude passage of endolumenal instruments
Moderate to severe Gastro-esophageal reflux disease (GERD)
Known hiatal hernia >3cm by history or as determined by UGI exam or endoscopy
Known GI motility disorder or pancreatic insufficiency/disease
Intra-operative Exclusion: Active peptic ulcer or hiatal hernia >3cm
Pregnancy.
Present Corticosteroid Use
History of inflammatory disease of GI tract
Severe coagulopathies, hepatic insufficiency or cirrhosis
History or present use of insulin or insulin derivatives for treatment of diabetes
Had Type II Diabetes Mellitus (as defined by HgbA1c >6.0) for greater than 2 years at the time of enrollment
Uncontrolled Type II DM (HgbA1c >7.0 at screening)
Patient has quit smoking within last 6 months at time of enrollment or plans to quit smoking in the next year
Patient has a history of drug or alcohol abuse or actively abusing either
Patient is presently being treated with medication for depression, psychosis, or other mood or eating disorder
Non-ambulatory or has significant impairment of mobility
Works for, or is first degree relative of investigator, study institution, or support staff involved in the study.
Known hormonal or genetic cause for obesity
Participating in another clinical study
Patient is on medications known to impact GI motility or gut hormones that cannot be discontinued prior to nuclear testing
Have work hours, family obligations or transportation issues that could interfere with patient returning for all scheduled evaluations, tests and nutritional counseling.
Lives >60 kilometers from investigator site.
Patient is not able to provide written informed consent
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jorge C Espinos, MD
Organizational Affiliation
Centro Medico Teknon
Official's Role
Principal Investigator
Facility Information:
Facility Name
Centro Medico Teknon
City
Barcelona
ZIP/Postal Code
08022
Country
Spain
12. IPD Sharing Statement
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ULTIMATE Study for Weight Loss
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