ULTIMATE Study for Weight Loss (ULTIMATE)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01771276
Recruitment Status : Completed
First Posted : January 18, 2013
Last Update Posted : April 3, 2015
Information provided by (Responsible Party):
USGI Medical

Brief Summary:
The purpose of this study is to help find out more about how the Primary Obesity Surgery Endoluminal (POSE) procedure makes patients feel less hungry and fuller faster, leading to weight loss. In this study, USGI Medical wants to see if stomach emptying and gastro-intestinal hormone levels change after a POSE procedure with an increased (as compared to typical) number of anchors placed.

Condition or disease Intervention/treatment Phase
Obesity Device: g-Cath Suture Anchor Delivery Catheter Not Applicable

Detailed Description:
This study will use the USGI Medical Incisionless Operating Platform (IOP) to determine the affects of placing more Suture Anchors per patient (as compared to the current practice) in Primary Obesity Surgery Endoluminal(POSE). USGI wants to see if placing more anchors (particularly in the distal body/antrum region) significantly impacts primary weight loss, satiety, and metabolic outcomes.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 10 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Evaluating Impact of ULTIMATE Number of G-CATH EZ- Suture Anchors Placed Endoscopically on Motility, Metabolism, Satiety, and Weight Utilizing the Incisionless Operating Platform for the Treatment of Primary Obesity
Study Start Date : June 2012
Actual Primary Completion Date : December 2013
Actual Study Completion Date : December 2013

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Ultimate Anchor
Use of the g-Cath Suture Anchor Delivery Catheter and accessories in placing the ultimate number of anchors for weight loss.
Device: g-Cath Suture Anchor Delivery Catheter
Evaluate changes in emptying, hormones, satiety and weight loss with use of the g-Cath Suture Anchor Delivery Catheter in maximizing g-Cath Suture Anchor placement to as high as 25 anchors.

Primary Outcome Measures :
  1. Weight Loss [ Time Frame: 18 months ]
    Weight loss will be monitored and recorded on a monthly basis for up to 18 months post POSE with the proportion of subjects achieving ≥25% excess weight loss (EWL) at 12 months (Met Life criteria)being the primary efficacy endpoint

Secondary Outcome Measures :
  1. Gastric emptying [ Time Frame: Immediately Pre-procedure, & 2 & 6 months post procedure ]
    This test consists of determining if there is a Clinically significant change in the duration of a radioactive marker (which is non-absorbable, and free of any food components) in a stomach pre and post POSE. In order to carry out this test, a piece of food is marked with a radioactive isotope and, by using an abdominal gamma camera; detections of radioactivity are made in the stomach during the postprandial period.

Other Outcome Measures:
  1. Satiety [ Time Frame: Immediately Pre-procedure, & 2 & 6 months post procedure ]
    This test consists of determining if there is a Clinically significant change in Satiety pre and post POSE. The subjects ingest a nutritional drink (Ensure) at a constant rate of 30 mL per minute, constantly filling the glass with a perfusion pump (Gemini PC-2, IMED, San Diego, CA). (The subjects are not conscious of the volume being ingested.) The subjects are instructed to maintain consumption at the fill rate. Participants take note of their sensation of satiety with a graphical classification scale, which combines verbal descriptors on a scale of 0 to 5 (0 = no symptoms, 1 = first sensation of fullness [threshold]; 2 = light, 3 = moderate, 4 = severe, and 5 = maximum fullness or unbearable). The participants are told to stop taking the food product when a score of 5 is obtained. The maximum consumption of volume of the nutritional drink is recorded.

  2. Peptide Measurements [ Time Frame: Immediately Pre-procedure & 2 Months post procedure ]

    This test consists of determining if there is a Clinically significant change in peptides pre and post procedure.

    1. Samples to be collected when fasting and 30, 60, 90, and 120 minutes after a standard meal (A meal consisting of 400 calories is used), The meal must be consumed within 10 minutes.
    2. Samples to be collected by ELISA are: C-peptide, serum insulin, glucose, PYY, GLP-1 (active), leptin, and GIP. Total ghrelin level to be analyzed by RIA.

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Ages Eligible for Study:   21 Years to 60 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Has a BMI of >30 and <40
  • Male or female ≥21 yrs. of age and < 60 yrs. of age at time of enrollment
  • Patient has had no significant weight change (+/- 5% of total body weight) in last 6 months but has been able to lose significant weight in the past with diet and exercise.
  • Is a reasonable candidate for general anesthesia
  • Agrees not to have any additional weight loss interventional procedures or liposuction for at least 18 months following study enrollment and agrees not to take any prescription or over the counter weight loss medications for at least 1 year.
  • Physically and mentally able to comply with the visit schedule, ancillary testing, and behavior modification (diet and exercise) required for the study and agrees to study commitment requirements
  • Had successful completion of the pre-screening, nutritional and educational programs and psychological assessment supporting that the subject is an appropriate bariatric surgical candidate

Exclusion Criteria:

  • History of (or intra-operative evidence of) bariatric, gastric or esophageal surgery
  • Esophageal stricture or other anatomy and/or condition that could preclude passage of endolumenal instruments
  • Moderate to severe Gastro-esophageal reflux disease (GERD)
  • Known hiatal hernia >3cm by history or as determined by UGI exam or endoscopy
  • Known GI motility disorder or pancreatic insufficiency/disease
  • Intra-operative Exclusion: Active peptic ulcer or hiatal hernia >3cm
  • Pregnancy.
  • Present Corticosteroid Use
  • History of inflammatory disease of GI tract
  • Severe coagulopathies, hepatic insufficiency or cirrhosis
  • History or present use of insulin or insulin derivatives for treatment of diabetes
  • Had Type II Diabetes Mellitus (as defined by HgbA1c >6.0) for greater than 2 years at the time of enrollment
  • Uncontrolled Type II DM (HgbA1c >7.0 at screening)
  • Patient has quit smoking within last 6 months at time of enrollment or plans to quit smoking in the next year
  • Patient has a history of drug or alcohol abuse or actively abusing either
  • Patient is presently being treated with medication for depression, psychosis, or other mood or eating disorder
  • Non-ambulatory or has significant impairment of mobility
  • Works for, or is first degree relative of investigator, study institution, or support staff involved in the study.
  • Known hormonal or genetic cause for obesity
  • Participating in another clinical study
  • Patient is on medications known to impact GI motility or gut hormones that cannot be discontinued prior to nuclear testing
  • Have work hours, family obligations or transportation issues that could interfere with patient returning for all scheduled evaluations, tests and nutritional counseling.
  • Lives >60 kilometers from investigator site.
  • Patient is not able to provide written informed consent

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01771276

Centro Medico Teknon
Barcelona, Spain, 08022
Sponsors and Collaborators
USGI Medical
Principal Investigator: Jorge C Espinos, MD Centro Medico Teknon

Responsible Party: USGI Medical Identifier: NCT01771276     History of Changes
Other Study ID Numbers: TPR602
First Posted: January 18, 2013    Key Record Dates
Last Update Posted: April 3, 2015
Last Verified: April 2015

Keywords provided by USGI Medical:

Additional relevant MeSH terms:
Nutrition Disorders
Body Weight
Signs and Symptoms