Bariatric Endoscopy and NAFLD

NCT ID: NCT04669470

Last Updated: 2020-12-16

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-10-01

Study Completion Date

2023-12-31

Brief Summary

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Find out how bariatric endocopy will influence clinical course of non alcoholic fatty liver disease.

Detailed Description

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The study will test and investigate the impact of bariatric endoscopy (various types of intragastric balloons, endoscopic sleeve gastroplasty, aspiration therapy) on components of the metabolic syndrome in obese patients, especially on influencing non-alcoholic steatosis and steatohepatitis and signs of liver fibrotization and weight reduction. The method consists in performing a mini-invasive endoscopic procedure and, as a result, in reduced food intake.

Current state of knowledge:

Based on data evaluated according to EBM (Evidence Based Medicine), it is an indisputable fact that bariatric methods have a demonstrable effect not only on improving the parameters and regression of many metabolic syndromes, but also improve the course of non-alcoholic fatty liver disease (NAFLD). It is this nosological unit that is becoming the dominant cause of liver disease in developed countries and has two subunits, where simple hepatic steatosis (NAFL) is considered a benign disease, while the second, where fat accumulation in the liver is associated with the inflammatory process called non-alcoholic steatohepatitis (NASH). ) has serious consequences for the liver with the development of fibrotization leading to cirrhosis with all its adverse effects. Recently, however, it has been shown that even simple steatosis is not as benign as it seemed, but carries an independent risk for the patient due to an increased incidence of cardiovascular diseases, oncological manifestations and a higher incidence of metabolic syndrome manifestations. Classical bariatric endoscopy carries a number of risks associated with the patient for the surgical procedure, however, we also have less invasive methods of gradually more and more developing endoscopy and dreams of associated bariatric procedures with many times lower risk for the patient.

Conditions

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Obesity NAFLD Liver Steatosis Liver Fibrosis

Keywords

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Obesity NAFLD liver steatosis liver fibrosis bariatric endoscopy weight lose

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Group with adjustable IGB

Group Type ACTIVE_COMPARATOR

bariatric endoscopy, mainly intragastric baloons, plication of stomach too

Intervention Type PROCEDURE

bariatric endoscopy, mainly intragastric baloons, plication of stomach too

Group with nin-adjustable IGB

Group Type ACTIVE_COMPARATOR

bariatric endoscopy, mainly intragastric baloons, plication of stomach too

Intervention Type PROCEDURE

bariatric endoscopy, mainly intragastric baloons, plication of stomach too

Interventions

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bariatric endoscopy, mainly intragastric baloons, plication of stomach too

bariatric endoscopy, mainly intragastric baloons, plication of stomach too

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Age between 21-64 years;
2. BMI \>30 Kg/m2
3. Must be able to comply with all study requirements for the duration of the study as outlined in the protocol. This includes complying with the visit schedule as well as study specific procedures such as: clinical assessment , endoscopy, radiography, as well as laboratory investigations.
4. Must be able to understand and be willing to provide written informed consent.

Exclusion Criteria

* Subjects meeting any of the following exclusionary criteria cannot be enrolled in the study:

1. Achalasia and any other esophageal motility disorders
2. Heart diseases: unstable angina, myocardial infarction within the past year, or heart disease classified within the New York Heart Association's Class III or IV functional capacity.
3. Hypertension: uncontrolled hypertension during last 3 month
4. Severe renal, hepatic, pulmonary disease or cancer;
5. GIT stenosis or obstruction
6. Pregnancy or breastfeeding
7. Impending gastric surgery 60 days post intervention;
8. Currently participating in other study
9. Celiac disease
10. History of bariatric surgery
11. Chronic or recent acute pancreatitis
12. Type 2 diabetes with insuline medication or type 1 diabetes
13. Hematologic disease or disease with impairment of hemocoagulation
14. Decompensated psychiatric disease
15. Autoimmune disease with chronic glucocorticoid or imunosupressive medications
16. Uncontroled disease of thyroid gland
17. Excesive abuse of addictive substances such alcohol or other
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital Olomouc

OTHER

Sponsor Role collaborator

University Hospital Ostrava

OTHER

Sponsor Role collaborator

Palacky University

OTHER

Sponsor Role collaborator

University of Ostrava

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Adam Vasura, MD

Role: STUDY_CHAIR

- Department of gastroenterology, hepatology and pancreatology, Internal clinic, University hospital Ostrava

Evzen Machytka

Role: STUDY_CHAIR

Department of gastroenterology, hepatology and pancreatology, Internal clinic, University hospital Ostrava

Locations

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Department of gastroenterology, hepatology and pancreatology

Ostrava, , Czechia

Site Status RECRUITING

Countries

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Czechia

Central Contacts

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Adam Vasura

Role: CONTACT

Phone: 420597374191

Email: [email protected]

Facility Contacts

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Adam Vasura

Role: primary

References

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Fakhry TK, Mhaskar R, Schwitalla T, Muradova E, Gonzalvo JP, Murr MM. Bariatric surgery improves nonalcoholic fatty liver disease: a contemporary systematic review and meta-analysis. Surg Obes Relat Dis. 2019 Mar;15(3):502-511. doi: 10.1016/j.soard.2018.12.002. Epub 2018 Dec 6.

Reference Type BACKGROUND
PMID: 30683512 (View on PubMed)

Machytka E, Klvana P, Kornbluth A, Peikin S, Mathus-Vliegen LE, Gostout C, Lopez-Nava G, Shikora S, Brooks J. Adjustable intragastric balloons: a 12-month pilot trial in endoscopic weight loss management. Obes Surg. 2011 Oct;21(10):1499-507. doi: 10.1007/s11695-011-0424-z.

Reference Type BACKGROUND
PMID: 21553304 (View on PubMed)

Leoni S, Tovoli F, Napoli L, Serio I, Ferri S, Bolondi L. Current guidelines for the management of non-alcoholic fatty liver disease: A systematic review with comparative analysis. World J Gastroenterol. 2018 Aug 14;24(30):3361-3373. doi: 10.3748/wjg.v24.i30.3361.

Reference Type BACKGROUND
PMID: 30122876 (View on PubMed)

Other Identifiers

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08_RVO-FNOs_2020

Identifier Type: -

Identifier Source: org_study_id