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Evaluation of EndoZip System in Obese Patients Who Failed to Reduce Weight With Non-surgical Weight-loss Methods

Primary Purpose

Obesity

Status
Unknown status
Phase
Not Applicable
Locations
Spain
Study Type
Interventional
Intervention
EndoZip System
Sponsored by
Nitinotes Surgical Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Obesity

Eligibility Criteria

21 Years - 70 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Age 21-70
  2. BMI ≥ 30 and ≤40 kg/m².
  3. Willingness to comply with the substantial behavioral modifications program as required by the procedure.
  4. Patients with history of failure with non-surgical weight-loss methods.
  5. Willingness to follow protocol requirements, including signed informed consent, routine follow-up schedule, completing laboratory tests, completing IWQOL questionnaire and completing the medically supervised diet and behavior modification program.
  6. Residing within a reasonable distance from the investigator's office and able to travel to the investigator to complete all routine follow- up visits.
  7. Ability to give informed consent.
  8. Women of childbearing potential (i.e., not post-menopausal or surgically sterilized) must agree to use adequate birth control methods.

Exclusion Criteria:

  1. Prior surgery of any kind on the gastrointestinal tract (except uncomplicated cholecystectomy or appendectomy).
  2. Patients with history of small bowel or colonic obstruction, and/or adhesive peritonitis and/or abdominal adhesions.
  3. Patients with any inflammatory disease
  4. Patients with history of cancer in the gastrointestinal tract.
  5. Potential upper gastrointestinal bleeding conditions such as a history of angioectasias.
  6. A known gastric mass or gastric polyps > 1 cm in size.
  7. Patients with TG >500 or LDL >190
  8. A known hiatal hernia > 4cm of axial displacement of the z-line above the diaphragm or severe or intractable gastro-esophageal reflux symptoms while on maximal medical therapy.
  9. A structural abnormality in the esophagus or pharynx such as a stricture or diverticulum that could impede passage of the endoscope.
  10. Patient with motility disorders of the GI tract or intractable constipation
  11. Patients with known coagulation disorder (INR >1.5) or on anticoagulation therapy.
  12. Type 1 diabetes or Type 2 diabetes with a HgbA1c >8 in 6 weeks prior the procedure or use of any medication for diabetes other than metformin. Patients with any serious health condition unrelated to their weight that would increase the risk of endoscopy
  13. Patients with chronic abdominal pain
  14. Patients with hepatic insufficiency or cirrhosis
  15. Patients that used an intragastric device for weight loss within 2 years prior to this study.
  16. Patients with psychological health questionnaire-9 (PHQ-9) score of 10 or higher.
  17. Patients receiving daily prescribed treatment with high dose aspirin (> 100mg daily), anti-inflammatory agents, anticoagulants or other gastric irritants.
  18. Patients with history or current abuse of drugs or alcohol
  19. Patients who are unable or unwilling to take prescribed proton pump inhibitor medication
  20. egg, milk, or wheat allergy (unable to go through the GEBT)
  21. Patients who are pregnant or breast-feeding.
  22. Patients who are taking medications that cause weight loss
  23. Patients with Severe cardiopulmonary disease or other serious organic disease which might include known history of coronary artery disease, Myocardial infarction within the past 12 months, poorly-controlled hypertension, required use of NSAIDs
  24. Patients taking medications on specified hourly intervals that may be affected by changes to gastric emptying, such as anti-seizure or anti-arrhythmic medications
  25. Patients who are taking corticosteroids, immunosuppressants, and narcotics
  26. Symptomatic congestive heart failure, cardiac arrhythmia or unstable coronary artery disease.
  27. Pre-existing respiratory disease such as chronic obstructive pulmonary disease (severe COPD), pneumonia or cancer.
  28. Diagnosis of autoimmune connective tissue disorder (e.g. lupus, HIV, erythematous, scleroderma) or immunocompromised.
  29. Specific diagnosed genetic disorder such as Prader Willi syndrome (motility disorder)
  30. Eating disorders including night eating syndrome (NES), bulimia, binge eating disorder, or compulsive overeating
  31. Known history of endocrine disorders affecting weight such as uncontrolled hypothyroidism.

Sites / Locations

  • Hospital Universitario HM SanchinarroRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

EndoZip System

Arm Description

The Nitinotes EndoZip system is designed to allow for the creation of multiple internal gastric segmentation (4-8) in the stomach by using an endoscopic approach. The system allows the forming of wall-to-wall longitudinal attachments of the anterior and posterior stomach walls, creating multiple strictures within. Creation of this segmentation may significantly reduce gastric volume, may affect gastric motility and consequently, reduce weight.

Outcomes

Primary Outcome Measures

Mean percent of total body weight loss (%TBWL) after 12 months
Percent of TBWL from baseline (prior to EndoZip procedure) and 12 month post EndoZip
Percentage of patients with a reduction in %TBWL of at least 5% at 12 months.

Secondary Outcome Measures

Full Information

First Posted
February 21, 2021
Last Updated
August 16, 2021
Sponsor
Nitinotes Surgical Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04773795
Brief Title
Evaluation of EndoZip System in Obese Patients Who Failed to Reduce Weight With Non-surgical Weight-loss Methods
Official Title
Evaluation of EndoZip System in Obese Patients Who Failed to Reduce Weight With Non-surgical Weight-loss Methods
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Unknown status
Study Start Date
June 30, 2021 (Actual)
Primary Completion Date
June 30, 2022 (Anticipated)
Study Completion Date
December 30, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nitinotes Surgical Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
A multicenter, prospective, single-arm, open-label, controlled clinical trial aimed to evaluate the safety and effectiveness of the EndoZip system procedure, coupled with lifestyle modifications, for weight reduction in obese patients with BMI of 30-40 kg/m2.
Detailed Description
study will include up to 45 (10-20 patients per site), ages of 21 -70 of obese patients who failed to reduce weight with non-surgical weight-loss methods. The duration for each participant will be 12 months and will include the following follow up visits and procedures: Office visits: screening, 1 week, and 1, 2, 4, 6, 8, 10, and 12 month(s) Remote follow up (by Phone): 3, 5, 7, 9, and 11 month(s) Endoscopy procedure: baseline, 2 and 6 months post EndoZip procedure Motility evaluation by Gastric Emptying Breath Test (GEBT): baseline, 6 months Physical examination, vital signs, waist circumference and BMI: baseline, 1 week, 1, 2, 4, 6, 8, 10 and 12 months Blood tests: baseline,2, 6 and 12 months IWQOL-Lite: baseline, 2, 6 and 12 months Psychological health questionnaire-9 (PHQ-9) :baseline Sleep Apnea (only for the relevant population): baseline 2, 6 and 12 months The patient will required to follow a specific diet and to have a physical activity during the study period ( 12 month).

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
45 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
EndoZip System
Arm Type
Experimental
Arm Description
The Nitinotes EndoZip system is designed to allow for the creation of multiple internal gastric segmentation (4-8) in the stomach by using an endoscopic approach. The system allows the forming of wall-to-wall longitudinal attachments of the anterior and posterior stomach walls, creating multiple strictures within. Creation of this segmentation may significantly reduce gastric volume, may affect gastric motility and consequently, reduce weight.
Intervention Type
Device
Intervention Name(s)
EndoZip System
Intervention Description
The Nitinotes EndoZip system is designed to allow for the creation of multiple internal gastric segmentation (4-8) in the stomach by using an endoscopic approach. The system allows the forming of wall-to-wall longitudinal attachments of the anterior and posterior stomach walls, creating multiple strictures within. Creation of this segmentation may significantly reduce gastric volume, may affect gastric motility and consequently, reduce weight.
Primary Outcome Measure Information:
Title
Mean percent of total body weight loss (%TBWL) after 12 months
Description
Percent of TBWL from baseline (prior to EndoZip procedure) and 12 month post EndoZip
Time Frame
12 month
Title
Percentage of patients with a reduction in %TBWL of at least 5% at 12 months.
Time Frame
12 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Age 21-70 BMI ≥ 30 and ≤40 kg/m². Willingness to comply with the substantial behavioral modifications program as required by the procedure. Patients with 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, completing IWQOL questionnaire and completing the medically supervised diet and behavior modification program. 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: Prior surgery of any kind on the gastrointestinal tract (except uncomplicated cholecystectomy or appendectomy). Patients with history of small bowel or colonic obstruction, and/or adhesive peritonitis and/or abdominal adhesions. Patients with any inflammatory disease Patients with history of cancer in the gastrointestinal tract. Potential upper gastrointestinal bleeding conditions such as a history of angioectasias. A known gastric mass or gastric polyps > 1 cm in size. Patients with TG >500 or LDL >190 A known hiatal hernia > 4cm of axial displacement of the z-line above the diaphragm or severe or intractable gastro-esophageal reflux symptoms while on maximal medical therapy. A structural abnormality in the esophagus or pharynx such as a stricture or diverticulum that could impede passage of the endoscope. Patient with motility disorders of the GI tract or intractable constipation Patients with known coagulation disorder (INR >1.5) or on anticoagulation therapy. Type 1 diabetes or Type 2 diabetes with a HgbA1c >8 in 6 weeks prior the procedure or use of any medication for diabetes other than metformin. Patients with any serious health condition unrelated to their weight that would increase the risk of endoscopy Patients with chronic abdominal pain Patients with hepatic insufficiency or cirrhosis Patients that used an intragastric device for weight loss within 2 years prior to this study. Patients with psychological health questionnaire-9 (PHQ-9) score of 10 or higher. Patients receiving daily prescribed treatment with high dose aspirin (> 100mg daily), anti-inflammatory agents, anticoagulants or other gastric irritants. Patients with history or current abuse of drugs or alcohol Patients who are unable or unwilling to take prescribed proton pump inhibitor medication egg, milk, or wheat allergy (unable to go through the GEBT) Patients who are pregnant or breast-feeding. Patients who are taking medications that cause weight loss Patients with Severe cardiopulmonary disease or other serious organic disease which might include known history of coronary artery disease, Myocardial infarction within the past 12 months, poorly-controlled hypertension, required use of NSAIDs Patients taking medications on specified hourly intervals that may be affected by changes to gastric emptying, such as anti-seizure or anti-arrhythmic medications Patients who are taking corticosteroids, immunosuppressants, and narcotics Symptomatic congestive heart failure, cardiac arrhythmia or unstable coronary artery disease. Pre-existing respiratory disease such as chronic obstructive pulmonary disease (severe COPD), pneumonia or cancer. Diagnosis of autoimmune connective tissue disorder (e.g. lupus, HIV, erythematous, scleroderma) or immunocompromised. Specific diagnosed genetic disorder such as Prader Willi syndrome (motility disorder) 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.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Ravit Peled
Phone
+972 526145354
Email
ravit@nitinotesurgical.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ravit Peled
Organizational Affiliation
NiTiNotes Ltd
Official's Role
Study Director
Facility Information:
Facility Name
Hospital Universitario HM Sanchinarro
City
Madrid
ZIP/Postal Code
28050
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gontrand N López, MD
Phone
+34 917567984
Email
gontrandlopeznava@gmail.com
First Name & Middle Initial & Last Name & Degree
Anna M Castillo
Phone
+34 913585236
Email
secretaria@digestivolopeznava.com
First Name & Middle Initial & Last Name & Degree
Gontrand N López, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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Evaluation of EndoZip System in Obese Patients Who Failed to Reduce Weight With Non-surgical Weight-loss Methods

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