Treatment of IPF With Laparoscopic Anti-Reflux Surgery

NCT ID: NCT01982968

Last Updated: 2021-10-25

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

58 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-12-31

Study Completion Date

2017-11-30

Brief Summary

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This study will test the hypothesis that treatment with laparoscopic anti-reflux surgery in subjects with idiopathic pulmonary fibrosis (IPF) and abnormal gastroesophageal reflux (GER) will slow the decline of forced vital capacity (FVC) over 48 weeks.

Detailed Description

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This protocol proposes to test the following hypothesis: Treatment with laparoscopic anti-reflux surgery in subjects with idiopathic pulmonary fibrosis (IPF) and abnormal gastroesophageal (GER) reflux will slow the decline of forced vital capacity (FVC) over 48 weeks. This study will randomize approximately 58 subjects with IPF and abnormal acid reflux on 24-hour impedance / pH monitoring to laparoscopic anti-reflux surgery or standard care (randomization ratio 1:1). Subjects will be followed for 48 weeks or until the time of lung transplantation or death.

We aim to achieve the following: determine the impact of laparoscopic anti-reflux surgery on change in FVC over 48 weeks in patients with IPF and abnormal GER; correlate the reduction in acid and non-acid reflux events with the change in FVC over 48 weeks in patients with IPF and abnormal GER; determine the safety of laparoscopic anti-reflux surgery in patients with IPF and abnormal GER; explore the impact of laparoscopic anti-reflux surgery on key secondary endpoints over 48 weeks in patients with IPF and abnormal GER; identify molecular markers of IPF disease activity and gastroesophageal reflux in biological samples from patients with IPF and abnormal GER.

Conditions

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Idiopathic Pulmonary Fibrosis Gastroesophageal Reflux

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Control

Subjects to receive standard anti-reflux treatment per clinical discretion

Group Type NO_INTERVENTION

No interventions assigned to this group

Surgery

Subjects will receive laparoscopic fundoplication surgery

Group Type ACTIVE_COMPARATOR

Surgery

Intervention Type PROCEDURE

Full fundoplication surgery for the treatment of abnormal GER

Interventions

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Surgery

Full fundoplication surgery for the treatment of abnormal GER

Intervention Type PROCEDURE

Other Intervention Names

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Nissen fundoplication Laparoscopic fundoplication Laparoscopic anti-reflux surgery

Eligibility Criteria

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Inclusion Criteria

* Confirmed diagnosis of idiopathic pulmonary fibrosis
* Abnormal GER on 24-hour pH monitoring (DeMeester score \> 14.7)
* Able to provide informed consent
* Willing to undergo laparoscopic anti-reflux surgery

Exclusion Criteria

* FVC \< 50% predicted
* FEV1/FVC ratio \< 0.65
* Resting room air PaO2 \< 60mm Hg
* Unable to walk 50 meters on 6 minute walk test
* Acute respiratory illness in last 12 weeks
* Experimental medication for IPF in last 28 days
* Listed for lung transplantation at screening
* Unable to safely undergo surgery
* History of esophageal / bariatric / gastric surgery
* History of cancer (other than non-melanoma skin cancer) in last 3 years
* Pregnant at time of screening or enrollment
* Unable to obtain pre-authorized approval from a third party payer for surgery and related costs
* Life expectancy \< 48 weeks due to another illness
* BMI \> 35
* Known severe pulmonary hypertension (mean pressure \> 35 mm Jg on RHC; RVSP \> 50 mm Hg on ECHO)
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Harold R Collard, MD

Role: PRINCIPAL_INVESTIGATOR

University of California, San Francisco

Ganesh Raghu, MD

Role: PRINCIPAL_INVESTIGATOR

University of Washington

Kevin J Anstrom, PhD

Role: PRINCIPAL_INVESTIGATOR

Duke University

Locations

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University of California

San Francisco, California, United States

Site Status

University of Chicago

Chicago, Illinois, United States

Site Status

University of Michigan

Ann Arbor, Michigan, United States

Site Status

University of Washington

Seattle, Washington, United States

Site Status

University of Wisconsin

Madison, Wisconsin, United States

Site Status

Countries

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United States

References

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Raghu G, Pellegrini CA, Yow E, Flaherty KR, Meyer K, Noth I, Scholand MB, Cello J, Ho LA, Pipavath S, Lee JS, Lin J, Maloney J, Martinez FJ, Morrow E, Patti MG, Rogers S, Wolters PJ, Yates R, Anstrom KJ, Collard HR. Laparoscopic anti-reflux surgery for the treatment of idiopathic pulmonary fibrosis (WRAP-IPF): a multicentre, randomised, controlled phase 2 trial. Lancet Respir Med. 2018 Sep;6(9):707-714. doi: 10.1016/S2213-2600(18)30301-1. Epub 2018 Aug 9.

Reference Type RESULT
PMID: 30100404 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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1UM1HL119089

Identifier Type: NIH

Identifier Source: secondary_id

View Link

Pro00049804

Identifier Type: -

Identifier Source: org_study_id