Radiofrequency Ablation for Barrett Oesophagus With Low Grade Dysplasia - Full Text View

Purpose

Radiofrequency ablation versus endoscopic surveillance in the management of low grade dysplasia in Barrett oesophagus: a multicentric randomised controlled trial.

Condition	Intervention	Phase
Barrett Oesophagus Low Grade Dysplasia	Procedure: Endoscopic radiofrequency ablation Other: Endoscopic surveillance	Phase 2


Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Endoscopic Radiofrequency Ablation for Barrett Oesophagus With Low Grade Dysplasia: a Randomised Controlled Trial vs Endoscopic Surveillance

Resource links provided by NLM:

MedlinePlus related topics: Endoscopy

U.S. FDA Resources

Further study details as provided by Assistance Publique - Hôpitaux de Paris:

Primary Outcome Measures:

Prevalence of low grade dysplasia 3 years after randomization [ Time Frame: 3 years after randomization ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Prevalence of low grade dysplasia in each group [ Time Frame: 1 and 5 years after randomization ] [ Designated as safety issue: No ]
Rate of complete eradication of Barrett oesophagus [ Time Frame: 1, 3 and 5 years after randomization ] [ Designated as safety issue: No ]
Incidence of high grade dysplasia and adenocarcinoma [ Time Frame: 3, 5 years after randomization ] [ Designated as safety issue: No ]
Cost - efficacy comparison of the 2 strategies [ Time Frame: 5 years ] [ Designated as safety issue: No ]
Rate of complications in radiofrequency ablation group [ Time Frame: 5 years after randomization ] [ Designated as safety issue: Yes ]


Enrollment:	125
Study Start Date:	December 2010
Estimated Study Completion Date:	December 2018
Estimated Primary Completion Date:	June 2018 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Radiofrequency ablation Endoscopic radiofrequency ablation of BE	Procedure: Endoscopic radiofrequency ablation HALO device Use of HALO 360° device for the fist procedure and possible use of HALo 90° device for further treatment sessions Treatment zone of 12cm high maximum. Energy delivered 10 J/cm², power 300W
Active Comparator: Surveillance Endoscopic surveillance and PPI treatment	Other: Endoscopic surveillance Upper gastro-intestinal endoscopy every 6 to 12 month under propofol sedation with acetic acid magnification of mucosa and multiple biopsy samples.

Detailed Description:

Background: The occurrence of low grade dysplasia (LGD) in Barrett oesophagus (BE) is known as a pre-cancerous state. Current recommendation in case of LGD is a close endoscopic surveillance every 6 to 12 month and continuous Proton pomp inhibitor (PPI) treatment. Endoscopic radiofrequency ablation (RFA) has been demonstrated as an efficient treatment to eradicate high grade dysplasia (HGD) and most of LGD and BE.

Main aim of this study: To demonstrate that the prevalence of patients with LGD 3 years after a RFA treatment is lower than in a surveillance group.

Patients & Methods: French multicentric randomized controlled trial for patients with BE with confirmed LGD: RFA vs endoscopic surveillance.

120 patients are planned to be included for at least 40 patients randomized in each group.

Primary endpoint: Prevalence of LGD in each group 3 years after randomization

Secondary endpoints:

Prevalence of LGD in each group 1 and 5 years after randomization
Rate of complete eradication of BE at 1, 3 and 5 years after randomization
Incidence of HGD and adenocarcinoma at 3, 5 years after randomization
Rate of complications in RFA group after randomization
Cost - efficacy comparison of the 2 strategies

Eligibility


Ages Eligible for Study:	18 Years to 80 Years (Adult, Senior)
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

BE with certain LGD in at least one endoscopic biopsy sample
BE with maximal length of 12cm (Prague classification ≤ C12)
BE with minimal length of 1cm circumferentially or 3cm in case of a unique zone (Prague classification ≥ C1 or C0M3)
Patients aged between 18 and 80 years
Patients' consent for study enrollment
No contra-indications to general anaesthesia
Patients ability to take PPI oral medication
Patient affiliated to a social security system
No pregnancy and active contraceptions for women in age to procreate
In case of previous endoscopic mucosal resection for HGD in BE: at least one year of surveillance and 2 biopsy series with LGD without HGD

Exclusion Criteria:

BE length > 12cm or < 1cm circumferentially (< C1) or < 3cm focally (<M3)
HGD or adenocarcinoma needing a specific endoscopic or surgical treatment
Active peptic oesophagitis (Savary III or IV)
previous oesophagus cancer
previous endoscopic destruction treatment such as photodynamic therapy or plasma argon coagulation
previous Heller surgery
oesophagus stenosis
oesophagus varices
oesophagus pathology associated with sclerodermia
Severe coagulation disorders or thrombopenia
Anaesthesia contra-indications (ASA 4)
Life expectancy < 2 years
Disability to take PPI oral medication or follow the protocol surveillance schedule

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01360541

Locations


France
Gastroenterology and Endoscopy department, Cochin Hospital
Paris, France, 75014

Sponsors and Collaborators

Assistance Publique - Hôpitaux de Paris

Investigators


Principal Investigator:	Frederic PRAT, MD, PhD	Gastroenterology and Endoscopy department, Cochin Hospital

More Information


Responsible Party:	Assistance Publique - Hôpitaux de Paris
ClinicalTrials.gov Identifier:	NCT01360541 History of Changes
Other Study ID Numbers:	P081240
Study First Received:	May 24, 2011
Last Updated:	July 5, 2016
Health Authority:	France: Ministry of Health

Keywords provided by Assistance Publique - Hôpitaux de Paris:


Barrett oesophagus Low grade dysplasia Radiofrequency ablation

Additional relevant MeSH terms:


Hyperplasia Barrett Esophagus Pathologic Processes Digestive System Abnormalities	Digestive System Diseases Esophageal Diseases Gastrointestinal Diseases

ClinicalTrials.gov processed this record on September 28, 2016

Radiofrequency Ablation for Barrett Oesophagus With Low Grade Dysplasia (RF-DBG)