Effect of Long-Term Electrical Stimulation on LES Pressure and Esophageal Acid Exposure in Patients With GERD

NCT ID: NCT01574339

Last Updated: 2025-02-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-08-31

Study Completion Date

2016-12-31

Brief Summary

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The EndoStim LES Stimulation System is an investigational device intended to improve the LES pressure and restore Lower Esophageal Sphincter (LES) function in individuals suffering from Gastroesophageal Reflux Disease (GERD).

Detailed Description

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EndoStim has developed an investigational medical device specifically designed to deliver electrical stimulation to the LES and has completed two clinical feasibility studies using an external version of the EndoStim stimulation system in fifteen subjects. In these two short-term studies, electrical stimulation resulted in significant increases in LES pressure.

This study will further evaluate the safety of the procedure and its feasibility for use in this group of patients.

Conditions

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Gastroesophageal Reflux Disease

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

All enrolled subjects will receive a functioning device and have stimulation delivered throughout the study.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Treatment Arm

EndoStim LES Stimulation System

Group Type EXPERIMENTAL

EndoStim LES Stimulation System

Intervention Type DEVICE

The EndoStim LES Stimulation System comprises three components: an electrical stimulation lead, an implantable pulse generator (IPG) and an external programmer.

The IPG and stimulation lead are to be implanted within the subject's body using conventional laparoscopy. The device programmer is to be used by the study investigator and/or a technical representative.

Interventions

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EndoStim LES Stimulation System

The EndoStim LES Stimulation System comprises three components: an electrical stimulation lead, an implantable pulse generator (IPG) and an external programmer.

The IPG and stimulation lead are to be implanted within the subject's body using conventional laparoscopy. The device programmer is to be used by the study investigator and/or a technical representative.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Subject is between 21 - 70 years of age.
* Subject has a history of heartburn, regurgitation or both for \> 12 month prompting physician recommendation of continual daily use of PPI before study entry.
* Baseline GERD HRQL heartburn score following 10-14 days off PPI which is ≥ 20 and at least 10 points higher than the on PPI score
* Subject who are on standard medical therapy for 12 months or longer and experience discomfort or who are otherwise dissatisfied with GERD symptoms
* Subjects with a GERD condition that in the opinion of the PI justifies a minimally invasive reversible procedure prior to attempting anatomical change such as Nissen fundoplication
* Subject has an American Society of Anesthesiologists (ASA) Physical Status Classification I or II (or comparable local classification if any).
* Subject has exhibited excessive lower esophageal acid exposure during 24-hour pHmetry of antisecretory therapy performed within 6 months of screening visit; pH \< 4 for \> 5% of total time.
* Subject has a resting LES end expiratory pressure \> 5mm Hg and \< 15 mm Hg on a high resolution manometry within 6 months of enrollment.
* Subject has esophagitis ≤ Grade C (LA classification) on upper endoscopy within 6 months of enrollment.
* Subject has esophageal body contraction amplitude \> 30 mmHg for \> 50% of swallows and \> 50% peristaltic contractions on high resolution manometry.
* Subject has signed the informed consent form and is able to adhere to study visit schedule.

Exclusion Criteria

* Subject has any non-GERD esophageal motility disorders.
* Subject has gastroparesis.
* Subject has any significant multisystem diseases.
* Subject has an autoimmune or a connective tissue disorder (e.g. scleroderma, dermatomyositis, Calcinosis-Raynaud's-Esophagus, Sclerodactyly Syndrome (CREST), Sjogren's Syndrome, Sharp's Syndrome), requiring therapy in the preceding 2 years.
* Subject has Barrett's epithelium (\> M2; \> C1) or any grade of dysplasia.
* Subject has a hiatal hernia larger than 3 cm.
* Subject has a body mass index (BMI) greater than 35 kg/m2.
* Subject has Type 1 diabetes mellitus
* Subject has uncontrolled Type 2 diabetes mellitus (T2DM) defined as HbA1c \> 9.5 in the previous 6 months, or has T2DM for \> 10 years.
* Subject has a history of suspected or confirmed esophageal or gastric cancer.
* Subject has esophageal or gastric varices.
* Subject has significant cardiac arrhythmia or ectopy or significant cardiovascular disease.
* Subject has an existing implanted electrical stimulator (e.g., pacemaker, AICD).
* Subject requires chronic anticoagulant therapy.
* Subject has dysphagia or esophageal peptic stricture, excluding Schatzki's ring.
* Subject of child-bearing potential who is pregnant or intends to become pregnant during the trial period.
* Subject is currently enrolled in other potentially confounding research.
* History of any malignancy in the last 2 years.
* History of previous esophageal or gastric surgery, including nissen fundoplication.
* Subject has any condition that, at the discretion of the investigator or sponsor, would preclude participation in the trial.
Minimum Eligible Age

21 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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EndoStim Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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A. J. Bredenoord, Dr. med.

Role: PRINCIPAL_INVESTIGATOR

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

T. Horbach, PD. Dr. med.

Role: PRINCIPAL_INVESTIGATOR

Stadtkrankenhaus Schwabach, Schwabach, Germany

A. Escalona, Dr. med.

Role: PRINCIPAL_INVESTIGATOR

Hospital Clinico de la Pontificia Universidad Catolica de Chile, Santiago, Chile

Nageshwar Reddy, M.D.,

Role: PRINCIPAL_INVESTIGATOR

Asian Institute of Gastroenterology

Locations

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Hospital Clinico de la Pontificia Universidad Catolica de Chile

Santiago, , Chile

Site Status

San Ignacio

Bogotá, , Colombia

Site Status

Chinese University of Hong Kong (CUHK) / Prince of Whales

Hong Kong, , Hong Kong

Site Status

Asian Institute of Gastroenterology

Hyderabad, , India

Site Status

. Zalvador Zubiran National Institute of Medical Science and Nutrition

Mexico City, , Mexico

Site Status

AMC Amsterdam

Amsterdam, , Netherlands

Site Status

UMC Maastrcht

Maastricht, , Netherlands

Site Status

UMC Utrecht

Utrecht, , Netherlands

Site Status

North Shore Hospital

Auckland, Takapuna, New Zealand

Site Status

St. Thomas Hospital

London, , United Kingdom

Site Status

Countries

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Chile Colombia Hong Kong India Mexico Netherlands New Zealand United Kingdom

References

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Sidhu AS, Triadafilopoulos G. Neuro-regulation of lower esophageal sphincter function as treatment for gastroesophageal reflux disease. World J Gastroenterol. 2008 Feb 21;14(7):985-90. doi: 10.3748/wjg.14.985.

Reference Type BACKGROUND
PMID: 18286675 (View on PubMed)

Sanmiguel CP, Hagiike M, Mintchev MP, Cruz RD, Phillips EH, Cunneen SA, Conklin JL, Soffer EE. Effect of electrical stimulation of the LES on LES pressure in a canine model. Am J Physiol Gastrointest Liver Physiol. 2008 Aug;295(2):G389-94. doi: 10.1152/ajpgi.90201.2008.

Reference Type BACKGROUND
PMID: 18687754 (View on PubMed)

Kappelle WF, Bredenoord AJ, Conchillo JM, Ruurda JP, Bouvy ND, van Berge Henegouwen MI, Chiu PW, Booth M, Hani A, Reddy DN, Bogte A, Smout AJ, Wu JC, Escalona A, Valdovinos MA, Torres-Villalobos G, Siersema PD. Electrical stimulation therapy of the lower oesophageal sphincter for refractory gastro-oesophageal reflux disease - interim results of an international multicentre trial. Aliment Pharmacol Ther. 2015 Sep;42(5):614-25. doi: 10.1111/apt.13306. Epub 2015 Jul 8.

Reference Type DERIVED
PMID: 26153531 (View on PubMed)

Other Identifiers

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CS005

Identifier Type: -

Identifier Source: org_study_id

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