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Treatment of IPF With Laparoscopic Anti-Reflux Surgery (WRAP-IPF)

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: NCT01982968
Recruitment Status : Unknown
Verified October 2016 by University of California, San Francisco.
Recruitment status was:  Active, not recruiting
First Posted : November 13, 2013
Last Update Posted : October 26, 2016
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by (Responsible Party):
University of California, San Francisco

Brief Summary:
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.

Condition or disease Intervention/treatment Phase
Idiopathic Pulmonary Fibrosis Gastroesophageal Reflux Procedure: Surgery Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 58 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Weighing Risks and Benefits of Laparoscopic Anti-Reflux Surgery in Patients With Idiopathic Pulmonary Fibrosis
Study Start Date : December 2013
Estimated Primary Completion Date : November 2017
Estimated Study Completion Date : November 2017

Arm Intervention/treatment
No Intervention: Control
Subjects to receive standard anti-reflux treatment per clinical discretion
Active Comparator: Surgery
Subjects will receive laparoscopic fundoplication surgery
Procedure: Surgery
Full fundoplication surgery for the treatment of abnormal GER
Other Names:
  • Nissen fundoplication
  • Laparoscopic fundoplication
  • Laparoscopic anti-reflux surgery

Primary Outcome Measures :
  1. Forced vital capacity (FVC) [ Time Frame: 48 weeks ]
    Decline in FVC (in liters) between enrollment and 48 weeks.

Secondary Outcome Measures :
  1. Acid and non-acid reflux events [ Time Frame: 48 weeks ]
    Reduction in acid and non-acid reflux events from enrollment to week 48

  2. Safety of laparoscopic anti-reflux surgery [ Time Frame: 48 weeks ]
    Overall safety of laparoscopic anti-reflux surgery in patients with IPF and abnormal GER

  3. All-cause mortality [ Time Frame: 48 weeks ]
    Impact of anti-reflux surgery on all-cause mortality from enrollment to 48 weeks

  4. Non-elective hospitalization [ Time Frame: 48 weeks ]
    Impact on non-elective hospitalizations from enrollment to 48 weeks.

  5. Acute exacerbations [ Time Frame: 48 weeks ]
    Impact on acute exacerbations of IPF from enrollment to week 48.

  6. UCSD SOQB score [ Time Frame: 48 weeks ]
    Change in UCSD Shortness of Breath Questionnaire score from enrollment to week 48

  7. SGRQ Score [ Time Frame: 48 weeks ]
    Change in St. George's Respiratory Questionnaire score from enrollment to week 48

  8. 6-minute walk distance [ Time Frame: 48 weeks ]
    Change in 6-minute walk distance from enrollment to week 48

  9. Cough VAS [ Time Frame: 48 weeks ]
    Change in cough visual analog scale (VAS) from enrollment to week 48

  10. HRCT fibrosis score [ Time Frame: 48 weeks ]
    Change in HRCT fibrosis score from enrollment to week 48

Information from the National Library of Medicine

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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

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)

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): NCT01982968

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United States, California
University of California
San Francisco, California, United States
United States, Illinois
University of Chicago
Chicago, Illinois, United States
United States, Michigan
University of Michigan
Ann Arbor, Michigan, United States
United States, Washington
University of Washington
Seattle, Washington, United States
United States, Wisconsin
University of Wisconsin
Madison, Wisconsin, United States
Sponsors and Collaborators
University of California, San Francisco
National Heart, Lung, and Blood Institute (NHLBI)
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Principal Investigator: Harold R Collard, MD University of California, San Francisco
Principal Investigator: Ganesh Raghu, MD University of Washington
Principal Investigator: Kevin J Anstrom, PhD Duke University
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: University of California, San Francisco Identifier: NCT01982968    
Other Study ID Numbers: Pro00049804
1UM1HL119089 ( U.S. NIH Grant/Contract )
First Posted: November 13, 2013    Key Record Dates
Last Update Posted: October 26, 2016
Last Verified: October 2016
Keywords provided by University of California, San Francisco:
Idiopathic pulmonary fibrosis
Gastroesophageal reflux
Additional relevant MeSH terms:
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Gastroesophageal Reflux
Pulmonary Fibrosis
Idiopathic Pulmonary Fibrosis
Pathologic Processes
Esophageal Motility Disorders
Deglutition Disorders
Esophageal Diseases
Gastrointestinal Diseases
Digestive System Diseases
Lung Diseases
Respiratory Tract Diseases