A Study to Evaluate Safety and Effectiveness of G-POEM for Gastroparesis

Overview

Información sobre este estudio

The primary aim of this pilot and feasibility, hypothesis-generating study therefore is to evaluate the effect of peroral endoscopic pyloromyotomy (G-POEM) vs. sham endoscopic surgery on symptoms in patients with diabetic or idiopathic gastroparesis.

Gastroparesis is a disorder of gastric function characterized by delay in gastric emptying, frequently associated with chronic nausea and vomiting, early satiety, postprandial fullness, abdominal pain, and malnutrition that may require nutritional support. There are few effective treatments available; more recently, a procedure called G-POEM (gastric peroral endoscopic myotomy) has been advocated to relieve symptoms by improving gastric emptying; however, it is not clear whether this is safe or effective.

Elegibilidad para la participación

Los requisitos de elegibilidad de los participantes incluyen la edad, el sexo, el tipo y el estadio de la enfermedad, y los problemas de salud o tratamientos previos. Las pautas difieren de un estudio a otro e identifican quiénes pueden o no pueden participar. No hay garantía de que cada persona elegible que desee participar en un ensayo se inscribirá. Comunícate con el equipo del estudio para analizar la elegibilidad del estudio y la posible participación.

Inclusion Criteria:

  • Symptoms of chronic nausea or vomiting compatible with gastroparesis (idiopathic or diabetic) must be present for at least one year (does not have to be contiguous) prior to registration.
  • Must have a mean total Gastroparesis Cardinal Symptom Index (GCSI) score of ≥ 3 at screening visit.
  • Refractory gastroparesis, defined using our previously published data, as a failure to improve over the last 6 months, despite an adequate trial of one or more standard prokinetics (metoclopramide, erythromycin, prucalopride), antinauseants (5-HT3  antagonists, promethazine, prochlorperazine, dronabinol), or neuromodulators (mirtazapine, buspirone).
  • Moderate to severe delay in gastric emptying, defined as > 25% solid retained at 4 hours or > 75% retained at 2 hours hours or gastric emptying T half greater than 174 minutes. For inclusion, the qualifying gastric emptying scintigraphy will be the baseline gastric emptying test.
  • No evidence of mechanical obstruction based on upper GI endoscopy or upper GI series in their medical history.

Exclusion Criteria:

  • Another active disorder which could explain symptoms in the opinion of the investigator
  • Gastric retention of solids at 4 hours < 25% or < 75% at 2 hours.
  • Ongoing use of prokinetic agents (e.g., metoclopramide, erythromycin, prucalopride) GLP -1 analog or agonists, or drugs that slow down gastric emptying (narcotics). Neuromodulators such as tricyclic antidepressants (amitriptyline or nortriptyline) or others that are being used at stable doses for a month prior to randomization may continue at the discretion of the care provider.
  • Significant systemic illness such as chronic renal failure (adjusted for age) or liver disease as defined by Child-Pugh score of 10 or greater.
  • Poorly controlled diabetes with HbA1c of greater than 10% at time of screening.
  • New medications for gastroparesis-related symptoms started within 1 month prior to registration.
  • Pregnancy or nursing.
  • Failure to give informed consent.
  • Any other condition, which in the opinion of the investigator would impede compliance or hinder completion of the study.
  • Botox injection into the pylorus within 3 months prior to registration.
  • Allergy to eggs or Egg Beaters and Ensure.

Eligibility last updated 12/5/23. Questions regarding updates should be directed to the study team contact.

Sedes participantes de Mayo Clinic

Los estatus de los estudios cambian con frecuencia. Comunícate con el equipo del estudio para obtener la información más actualizada acerca de la posibilidad de participar.

Sede de Mayo Clinic Estatus Contacto

Rochester, Minn.

Investigador principal de Mayo Clinic

Michael Camilleri, M.D., D.Sc.

Cerrado; inscripción por invitación

¿Qué es esto? (?)
"Close"
El estudio no está abierto para todos los que cumplen con los criterios de elegibilidad, sino solamente para las personas que el equipo del estudio ha invitado a participar.

Contact information:

Deborah Eckert R.N.

(507) 538-5860

Eckert.Deborah@mayo.edu

Scottsdale/Phoenix, Ariz.

Investigador principal de Mayo Clinic

Pankaj Pasricha, M.B.B.S., M.D.

Cerrado; inscripción por invitación

¿Qué es esto? (?)
"Close"
El estudio no está abierto para todos los que cumplen con los criterios de elegibilidad, sino solamente para las personas que el equipo del estudio ha invitado a participar.

Contact information:

Guillermo Barahona Hernandez

(410) 603-8343

Barahona.Guillermo@mayo.edu

More information

Publicaciones

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CLS-20535469

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