Clinical trial NCT01054794: Temporary Gastric Electrical Stimulation for Gastroparesis
Official title: Temporary Gastric Neurostimulation for Gastroparesis
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Gastroparesis
Keywords: Gastroparesis
Gastric Electrical Stimulation
Lead sponsor: University of Calgary
Sponsor class: OTHER
First posted: 2010-01-22
Enrollment: 30
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: TREATMENT

Brief summary: This is a prospective study of temporary gastric mucosal electrical stimulation (tGES) in 30 patients with gastroparesis (GP). After a 7 day baseline assessment of symptoms, subjects will have an endoscopically-placed tGES lead implanted into the mucosa of the antrum. This lead is connected to a thin wire that runs up the esophagus and out the nostril, similar to a nasojejunal feeding tube, although much thinner. It is then attached to a programmable battery pack which provides the desired level of stimulation.

Patients will then be randomized to 7 days OFF or 7 days ON stimulation in a double-blind fashion. After 7 days, subjects will crossover to the other study arm (ie ON patients will be switched off; OFF patients will be switched on). Symptoms and QoL measures will be assessed at baseline, ON, and OFF periods. Serum ghrelin and other hormones, as well as EGG will be assayed after 6 days in each arm.


Eligibility criteria: Inclusion Criteria:

* Age of 18 or older
* Existing clinical diagnosis of gastroparesis for at least one year as judged by the study gastroenterologist based on past medical history, clinical symptoms
* Sufficiently symptomatic at time of proposed study (Minimum total baseline GCSI score of 1.5 or higher)
* Delayed gastric emptying (\>10% retention at 4 hours) on standard scintigraphic emptying study with patients off narcotics for at least 48 hours. Normal upper endoscopy (with the exception of small bezoars) since the onset of symptoms
* Medically fit to undergo endoscopy
* Able and willing to remain in Calgary for the duration of the study (baseline period excepted)
* Able to provide written informed consent

Exclusion Criteria:

* Clinical evidence (including physical exam and/or EKG) of significant cardiovascular, respiratory, renal, hepatic, gastrointestinal, hematological, neurological, psychiatric or other disease that may interfere with the objectives of the study and/or pose safety concerns
* Current use of anticoagulants, ASA, NSAIDS, clopidogrel, etc. which cannot safely be stopped for up to 5 days prior to the procedure in the opinion of the investigators
* Bleeding diathesis
* Severe immunocompromise
* Physical, mental, or compliance issues which in the opinion of the investigators may prevent the patient from completing the study
* Pregnant or breastfeeding females

Primary outcomes:
measure: Changes in patient symptoms during the ON and OFF periods of tGES stimulation.
timeFrame: daily x 6 days in each phase of study (ON and OFF)
Secondary outcomes:
measure: 1. Changes in serum ghrelin and leptin between ON and OFF periods of tGES stimulation in GP patients. 2. Changes in gastric electrical activity between ON and OFF periods of tGES stimulation in GP patients
timeFrame: Once during each study phase (ON and OFF)
Other outcomes:
Locations:
city: Calgary
country: Canada
facility: University of Calgary
state: Alberta
Study officials:
affiliation: University of Calgary, Faculty of Medicine
name: Christopher N Andrews, MD, FRCPC
role: PRINCIPAL_INVESTIGATOR
References: