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A Feasibility Study for the Treatment of Primary Obesity

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: NCT03837691
Recruitment Status : Active, not recruiting
First Posted : February 12, 2019
Last Update Posted : December 2, 2019
Information provided by (Responsible Party):
USGI Medical

Brief Summary:
This is a single-center, open-label, pilot study evaluating a treatment for obesity.

Condition or disease Intervention/treatment Phase
Obesity Device: Placement of Snowshoe Suture Anchors Behavioral: Moderate Intensity Diet & Exercise Program Not Applicable

Detailed Description:
This is a single-center, open-label, pilot study evaluating a treatment for obesity. The intent is to evaluate the safety and preliminary efficacy of a new Snowshoe suture placement pattern, Pose 2 (sutures placed in the mid + distal body without fundus), with a moderate intensity diet and exercise program. The procedure will be performed using the g-Cath EZ Delivery Catheter with Snowshoe Suture Anchors (AKA g-Cath or g-Cath EZ) and associated devices (g-Prox EZ, g-Lix and Transport), known collectively as the Incisionless Operating Platform (IOP). Efficacy will be evaluated based on changes in weight loss through 12 months. Adverse events will be recorded throughout the duration of the study.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 5 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Intervention Model Description: Five Patient Study
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Feasibility Study Examining Safety and Preliminary Effectiveness of a Procedural Technique Using an Endoscopic Suturing Device and Associated Devices for the Treatment of Primary Obesity
Actual Study Start Date : October 10, 2019
Estimated Primary Completion Date : October 2020
Estimated Study Completion Date : November 2020

Arm Intervention/treatment
Experimental: g-Cath EZ
Placement of Snowshoe suture anchors from g-Cath EZ Delivery Catheters, in a defined pattern in the mid and distal portions of the stomach, along with a moderate intensity diet & exercise program, to treat primary obesity.
Device: Placement of Snowshoe Suture Anchors
Snowshoe suture anchors from g-Cath EZ Delivery Catheters are placed in the stomach with the aid of a Transport, g-Lix and g-Prox device

Behavioral: Moderate Intensity Diet & Exercise Program
After placement of the snowshoe suture anchors in the stomach, subjects are asked to follow a moderate intensity diet and exercise program

Primary Outcome Measures :
  1. Primary weight loss intervention [ Time Frame: 12 months ]
    To evaluate the safety and preliminary effectiveness of the Pose 2 procedure using the g-Cath EZ Suture Anchor Delivery Catheter as a primary weight loss intervention.

Secondary Outcome Measures :
  1. Changes in gastric emptying [ Time Frame: 2 & 6 months ]
    To gather information on changes in gastric emptying breath test findings in order to correlate changes with weight loss outcomes.

Information from the National Library of Medicine

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Ages Eligible for Study:   22 Years to 60 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Provision of signed and dated informed consent form.
  2. Subject agrees to be compliant with study requirements and adhere to post-operative dietary & exercise recommendations for the duration of the study.
  3. Subjects between the ages of 22-60 years.
  4. If female, be either post-menopausal, surgically sterile, or agree to practice birth control during year of study and have negative serum HCG at screening/baseline.
  5. Have a Body Mass Index (BMI) of ≥ 35 and < 40 with one or more obesity related co-morbid conditions (defined by 1991 NIH Guidelines (Appropriateness Criteria for Bariatric Surgery: Beyond the NIH Guidelines)).

    1. Pre-diabetes - Fasting plasma glucose test >100 mg/dl but ≤125 or oral glucose tolerance test ≥140 mg/dl but <200.
    2. Diabetes - Individuals taking insulin and/or oral hypoglycemic medications or have a fasting glucose >126 mg/dl.
    3. Hypertension - SBP>140 or DBP>90 or the use of an antihypertensive medication.
    4. Dyslipidemia - Triglycerides > 250 mg/dl or cholesterol > 220 mg/dl or HDL < 35 mg/dl or LDL > 200 or use of lipid lowering medications.
    5. Sleep Apnea - A formal sleep study test consistent with this diagnosis; Epworth sleepiness scale ≥ 6; Polysomnography with respiratory disturbance index ≥ 10 hypopneic and/or apneic episodes per hour of sleep.
    6. Venous Stasis Disease - Presence or history of pretibial venous stasis ulcers.
    7. Chronic Joint Disease - Deterioration of joint cartilage and the formation of new bone (bone spurs) at the margins of the joints.
  6. Absence of current severe systemic disease (including, but not limited to: coronary artery disease, chronic obstructive pulmonary disease, congestive heart failure, cancer, and chronic renal disease).
  7. Agrees not to undergo any additional weight loss interventional procedures or liposuction for 12 months following study enrollment.
  8. Have not taken any prescription or over the counter weight loss medications or those that can suppress appetite/induce weight loss for at least 6 months and agrees not to utilize for 12 months following study enrollment (including all stimulant medication).
  9. Subjects must be willing to possibly forego any future weight loss procedures (i.e. Vertical Sleeve Gastrectomy) given the unknown long-term effects.
  10. Residing within a reasonable distance from the Investigator's treating office (~50 miles) and willing and able to travel to the Investigator's office to complete all routine follow-up visits.

Exclusion Criteria:

  1. History of (or intra-operative evidence of) prior bariatric, gastric or esophageal surgery.
  2. Esophageal stricture or other anatomy and/or condition that could preclude passage of endoluminal instruments or procedure execution.
  3. Moderate gastro-esophageal reflux disease (GERD), defined as symptoms that cause subject severe discomfort, compromise performance of daily activities, and/or condition is not entirely controlled with drug therapy.
  4. Large hiatal hernia (>3 cm) by history or as determined by pre-enrollment endoscopy.
  5. Pancreatic insufficiency/disease.
  6. History of gastroparesis or symptoms that would be suggestive of gastroparesis or generalized dysmotility (e.g. esophago-gastric motility issues and lower esophageal sphincter abnormalities).
  7. Pregnancy or plans of pregnancy in the next 12 months.
  8. History of a known diagnosis or pre-existing symptom of rheumatoid arthritis, scleroderma, system lupus, or other autoimmune connective tissue disorder.
  9. Immunosuppressive medications or systemic steroids (i.e., oral prednisone) within 6 months of Visit 1. Intranasal/inhaled steroids are acceptable.
  10. Unable or unwilling to avoid use of aspirin and/or non-steroidal anti-inflammatory drugs (NSAIDs), or other medications known to be gastric irritants beginning two weeks prior to enrollment and throughout the entire study.
  11. History of inflammatory disease of the GI tract; coagulation disorders; hepatic insufficiency or cirrhosis.
  12. Active gastric erosion, lesion, or gastric/duodenal ulcer.
  13. History of or current platelet or coagulation dysfunction, such as hemophilia.
  14. History or present use of insulin or insulin derivatives for treatment of diabetes.
  15. Type II Diabetes Mellitus (as defined by HgbA1c >6.5%) for greater than 11 years at the time of enrollment.
  16. If smoker, plans to quit smoking in the year after enrollment.
  17. Portal hypertension and/or varices.
  18. Patient has a history of drug or alcohol abuse or positive at screening for drugs of abuse.
  19. Present or history of psychosis, bipolar disease, or obsessive-compulsive disorder after pre-enrollment history and medical /psychological assessment.
  20. Beck Depression Inventory (Short) Score ≥ 12 and/or uncontrolled depression after pre-enrollment psychological and medical assessment.
  21. Patient score >2 in any of the 9 identified symptoms on the Gastroparesis Cardinal Symptom Index (GCSI)
  22. Patient with a 13C-Spirulina Gastric Emptying Breath Test (GEBT) result that is less than a kPCD/min of 34.4 at 120 minutes or 43 at 180 minutes
  23. Non-ambulatory or has significant impairment of mobility (i.e. cannot ambulate for 30 minutes).
  24. Known hormonal or genetic cause for obesity including untreated hypothyroidism (TSH >5.0 U/ml).
  25. Participating in another clinical study.
  26. Subjects with a personal history of allergic/anaphylactic reactions including hypersensitivity to the drugs or materials that will be utilized in the study procedure.
  27. Physician's assessment that the subject is not an appropriate candidate. If significant findings for depression and/or suicidal ideation are identified, the psychologist(s) assigned to the study will be contacted and arrangement will be made for immediate intervention according to the Institution's standard procedure.

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): NCT03837691

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United States, Minnesota
Mayo Clinic
Rochester, Minnesota, United States, 55905
Sponsors and Collaborators
USGI Medical
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Principal Investigator: Barham Abu Dayyeh, MD Mayo
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Responsible Party: USGI Medical Identifier: NCT03837691    
Other Study ID Numbers: 50527 TPR
First Posted: February 12, 2019    Key Record Dates
Last Update Posted: December 2, 2019
Last Verified: November 2019

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: Yes
Additional relevant MeSH terms:
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Nutrition Disorders
Body Weight
Signs and Symptoms