aspiration therapy in asian patients

Conditions: Obesity

Summary: this research project will provide insight into the efficacy and safety of aspiration therapy in the management of obesity and its comorbidities in the asian population, and will determine if there is a role for this novel endoscopic device in the treatment algorithm of obesity in the investigators' local regions.

obesity is a major global health problem and asians are equally affected. according to the latest behavioural risk factor survey in 2014, 20.8% of adults in hong kong have body mass index (bmi) belonging to the obese category. obesity is associated with a multitude of medical and psychological comorbidities that could cumulate in increased healthcare costs and impaired quality of life. as such, an effective treatment strategy for obesity is imperative. sustainable weight reduction by lifestyle measures alone is often difficult if not impossible. pharmacotherapy can provide additional weight reduction when used as an adjunct to lifestyle intervention but the efficacy is modest. the most effective method for weight reduction to date is bariatric surgery but this is limited by its invasiveness and irreversibility. the limitations of current obesity treatment has led to an increased interest in endoscopic treatment, which may be more effective than pharmacotherapy and less invasive and more reversible than bariatric surgery. the aspireassist® aspiration therapy system is a novel endoscopic therapy developed by aspire bariatrics inc. (king of prussia, united states) for treatment of obesity. the system takes advantage of percutaneous endoscopic gastrostomy (peg) tube technology to induce weight reduction by aspirating a portion of ingested meals from the stomach. in a pilot study involving 18 caucasian obese subjects randomly assigned in a 2:1 ratio to aspiration therapy group and lifestyle therapy only group, the weight reduction was 18.6% +/- 2.3% and 5.9% +/- 5.0% respectively. the present study aims to investigate the effectiveness and safety of this device in asian subjects.

Eligibility criteria:
inclusion criteria: 1. measured body mass index (bmi) of 27.5-55.0 kg/m2 at time of screening. 2. 21- 65 years of age (inclusive) at time of screening. 3. failed attempt for a duration equal to 3-months at weight loss by alternative approaches (e.g. supervised or unsupervised diets, exercise, behavioral modification programs) 4. stable weight (\<3% change in self-reported weight) over the previous 3 months at time of screening. 5. women of childbearing potential who agree to use at least one form of birth control (prescription hormonal contraceptives, diaphragm, intrauterine device (iud), condoms with or without spermicide, or voluntary abstinence) from time of study enrollment through study exit 6. willing and able to provide informed consent and comply with the protocol. exclusion criteria: 1. evidence of an eating disorder or major depression 2. history of gastrointestinal disease or previous gastric surgery that would increase the risk of the aspireassist® tube (a-tube) placement 3. severe co-existing medical diseases or malignancies 4. bleeding tendency (low platelet, coagulopathy including being on anti-coagulants) 5. pregnant/lactating