NCT02749071

Brief Summary

The purpose of this investigation is to demonstrate the safety and effectiveness of Lower Esophageal Sphincter (LES) Stimulation System in treating gastroesophageal reflux disease (GERD). This investigation is a multicenter, randomized, double-blind, sham-controlled study. After the implant procedure, subjects will be randomized to either the Treatment Group (immediate stimulation) or Control Group (delayed stimulation) for six months followed by an additional open-label phase in which all subjects will receive electrical stimulation. Subjects continue on stimulation treatment in an extended open-label follow-up phase through 5 years post-stimulation.

Trial Health

60
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
161

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started May 2016

Longer than P75 for not_applicable

Geographic Reach
4 countries

21 active sites

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

April 15, 2016

Completed
7 days until next milestone

First Posted

Study publicly available on registry

April 22, 2016

Completed
9 days until next milestone

Study Start

First participant enrolled

May 1, 2016

Completed
3.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2019

Completed
Last Updated

October 18, 2019

Status Verified

October 1, 2019

Enrollment Period

3.4 years

First QC Date

April 15, 2016

Last Update Submit

October 16, 2019

Conditions

Outcome Measures

Primary Outcomes (2)

  • Rate of device and/or procedure-related serious adverse events

    Rate of occurrence of device and/or procedure-related serious adverse events after 12 months

    12 months

  • Percentage of subjects achieving pH success (pH<4 for mo more than 5.3% of time or at least 50% improvement in pH compared to baseline)

    Comparison between treatment and control group: percentage of subjects achieving pH success ((pH\<4 for mo more than 5.3% of time or at least 50% improvement in pH compared to baseline)

    Comparison of 6 months to baseline data

Study Arms (2)

Control Group

SHAM COMPARATOR

This group will undergo laparoscopic implantation surgery. The device will not be activated: Sham EndoStim stimulation for first six months of study. It will be activated at the Month 6 visit and provide lower esophageal stimulation from Month 6 thru end of study.

Procedure: Laparoscopic implantation surgeryDevice: EndoStim stimulation from Month 6 thru end of studyDevice: Sham EndoStim stimulation for first six months of study

Treatment Group

EXPERIMENTAL

The group will undergo laparoscopic implantation surgery. The device will be activated two weeks post-implantation and the subject will receive EndoStim stimulation for first six months of study and continue with EndoStim stimulation from Month 6 thru end of study.

Procedure: Laparoscopic implantation surgeryDevice: EndoStim stimulation for first six months of studyDevice: EndoStim stimulation from Month 6 thru end of study

Interventions

Laparoscopic surgery to implant the pulse generator and bipolar lead.

Control GroupTreatment Group

Lower esophageal stimulation

Also known as: EndoStim Implantable Pulse Generator (IPG), lower esophageal stimulation
Treatment Group

Lower esophageal stimulation

Also known as: EndoStim Implantable Pulse Generator (IPG), lower esophageal stimulation
Control GroupTreatment Group

EndoStim device remains "off" (no stimulation delivered)

Control Group

Eligibility Criteria

Age22 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Able and willing to provide written informed consent
  • Able and willing to comply with required study procedures and follow-up schedule
  • years of age at the time of informed consent
  • Documented symptoms of gastroesophageal reflux disease (GERD) for longer than 6 months (regurgitation and/or heartburn which is defined as burning epigastric or substernal pain which responds to acid neutralization or suppression) which requires daily use of proton pump inhibitors (PPIs) or other anti-reflux drug therapy, who continue to have symptoms despite maximum medical therapy or are "intolerant" -severe side-effects (e.g. anaphylaxis or severe allergic reaction, recurrent C. difficile, severe hypomagnesaemia) to one PPI or mild/moderate side effect (e.g. nausea, vomiting, diarrhea or abdominal pain) to at least 2 PPIs of different chemical classes.
  • Symptomatic improvement on PPI therapy demonstrated by a composite GERD-health-related quality of life (HRQL) score of ≥20 off PPI, and a ≥10 point improvement on PPI compared to the off PPI composite GERD-HRQL score. Patients who meet the definition above of PPI intolerant are not required to have ≥10 point improvement. The on-PPI score to satisfy this criterion will be the score from the GERD-HRQL assessment completed after resuming PPIs following the Baseline visit.
  • Esophagitis ≤ Grade B (Los Angeles (LA) classification) as measured by upper endoscopy off PPI and H2 blockers for 10-14 days
  • Esophageal body contraction amplitude \> 30 mmHg for \> 30% of swallows and \> 30% peristaltic contractions on HRM or ≥ 30% peristaltic contractions with DCI \>450.
  • Suitable surgical candidate able to undergo general anesthesia and laparoscopic surgery

You may not qualify if:

  • Previous EndoStim LES System implant and/or implant attempt
  • Previous surgery involving the gastroesophageal junction or the lead implant site, such as a Nissen fundoplication
  • Previous endoscopic intervention for the treatment of GERD and/or Barrett's esophagus
  • Hiatal hernia larger than 3 cm as determined by endoscopy
  • History of gastroparesis
  • Any non-GERD esophageal motility disorders that in the opinion of investigator precludes an anti-reflux procedure
  • History of or known esophageal stricture or significant esophageal anatomic abnormalities (obstructive lesions, etc.)
  • Barrett's esophagus or any grade of dysplasia
  • Documented history of esophagitis Grade C or D (LA Classification)
  • History of suspected or confirmed esophageal or gastric cancer
  • Esophageal or gastric varices
  • Symptoms of dysphagia more than once per week every week within the last 3 months
  • Unable to tolerate withdrawal from H2 Blockers or PPI medications
  • Suspected or known allergies to titanium, platinum, iridium, stainless steel, silicone, epoxy, or nylon
  • Body mass index (BMI) \> 35 kg/m2
  • +11 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (21)

St. Joseph's Hospital and Medical Center

Phoenix, Arizona, 85013, United States

Location

HonorHealth Research Institute

Scottsdale, Arizona, 85258, United States

Location

University of Southern California (USC)

Los Angeles, California, 90033, United States

Location

Stanford Center for Clinical Research

Stanford, California, 94305, United States

Location

Institute of Esophageal and Reflux Surgery

Englewood, Colorado, 80113, United States

Location

University of South Florida

Tampa, Florida, 33606, United States

Location

Cornell University Weill Medical College

New York, New York, 10021, United States

Location

Columbia University Medical Center

New York, New York, 10032, United States

Location

University of North Carolina

Chapel Hill, North Carolina, 27599, United States

Location

Carolinas HealthCare System

Charlotte, North Carolina, 28260, United States

Location

The MetroHealth System

Cleveland, Ohio, 44109, United States

Location

The Ohio State University Medical Center

Columbus, Ohio, 43210, United States

Location

Oregon Clinic

Portland, Oregon, 97213, United States

Location

Oregon Health Science University

Portland, Oregon, 97239, United States

Location

Allegheny Health Network Research Institute

Pittsburgh, Pennsylvania, 15224, United States

Location

Vanderbilt University Medical Center

Nashville, Tennessee, 37212, United States

Location

Baylor Scott & White Research Institute

Round Rock, Texas, 78665, United States

Location

Virginia Commonwealth University

Richmond, Virginia, 23298, United States

Location

Universitaire Ziekenhuizen Leuven

Leuven, Belgium

Location

Clinical Trial Center Maastricht

Maastricht, Netherlands

Location

University College London

London, United Kingdom

Location

Related Links

MeSH Terms

Conditions

Gastroesophageal Reflux

Condition Hierarchy (Ancestors)

Esophageal Motility DisordersDeglutition DisordersEsophageal DiseasesGastrointestinal DiseasesDigestive System Diseases

Study Officials

  • Nicholas J Shaheen, MD, MPH

    University of North Carolina

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
CROSSOVER
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 15, 2016

First Posted

April 22, 2016

Study Start

May 1, 2016

Primary Completion

October 1, 2019

Study Completion

October 1, 2019

Last Updated

October 18, 2019

Record last verified: 2019-10

Data Sharing

IPD Sharing
Will not share

Locations