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Laryngopharyngeal RefluxNCT03463395

Efficacy of Reza Band for the Treatment of Laryngopharyngeal Reflux

A study testing Reza band in people with Laryngopharyngeal Reflux, run by Medical College of Wisconsin at 1 site in United States.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

We hypothesize that tissue and salivary pepsin will resolve after 12 weeks use of Reza Band, but not following standard of care alone. Additionally, RFS, RSI and inflammatory cytokines (IL -1β, -6, and -8) will decrease to normative levels following 12 weeks use of Reza Band, but not with standard of care alone. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Laryngopharyngeal Reflux
What is being tested?
Reza band
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
1 siteUnited States
Study dates
Jul 2020to Nov 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Clinical diagnosis of laryngopharyngeal reflux (LPR).
  • Age ≥ 18 years.
  • Reflux Finding Score (RFS) of ≥ 7 and an Reflux Symptom Index (RSI) ≥ 13.
  • Patients should be able to tolerate an endoscopy.
  • Patients must be deemed able to comply with the treatment plan and follow-up schedule.
  • Enrollment on an interventional postoperative study is allowed if study device/agents do not overlap i.e. no other investigational device or medication for the treatment of LPR is permitted during the duration of this study.
  • Patients must provide study-specific informed consent prior to study entry.

Who cannot join

  • Patient should not be on anticoagulants
  • Currently being treated with another investigational medical device and/or drug.
  • Currently receiving treatment for sleep apnea with continuous positive airway pressure (CPAP).
  • The patient is female and is of childbearing potential and is not using an acceptable method of birth control or is pregnant or breast-feeding.
  • Previous head or neck surgery or radiation.
  • Carotid artery disease, thyroid disease or history of cerebral vascular disease.
Show all 10Show fewer
  • Suspected esophageal cancer.
  • Has either a pacemaker or implanted cardioverter defibrillator (ICD).
  • Nasopharyngeal cancer.
  • Previously undergone Nissen Fundoplication.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Froedtert Hospital and Medical College of Wisconsin

    Milwaukee, Wisconsin, 53226

Other trials in United States

About this study

We hypothesize that tissue and salivary pepsin will resolve after 12 weeks use of Reza Band, but not following standard of care alone. Additionally, RFS, RSI and inflammatory cytokines (IL -1β, -6, and -8) will decrease to normative levels following 12 weeks use of Reza Band, but not with standard of care alone.

Primary Objective The primary objective is to evaluate the efficacy of the Reza Band for the treatment of LPR. We propose a pilot clinical trial to test the hypothesis that the Reza Band is effective for the treatment of LPR, measured by resolution of pepsin and decrease to normative values for RSI, Reflux Finding Score (RFS) and inflammatory cytokines.

The long-term goal is to determine the efficacy of the Reza Band in the sequential progression of reflux-attributed laryngeal inflammatory and neoplastic disease.

Read the detailed description

We propose a prospective cohort study. Sixty patients ≥ 18 years of age presenting to our laryngology outpatient clinic with LPR, with an RFS ≥ 7 and an RSI ≥ 13, not on anticoagulants, able to tolerate an endoscopy and consent to participate in this research study will be included. The study will consist of two cohorts. Cohort one will receive standard care (n = 30), and cohort two will receive standard care plus the Reza Band (to be worn as recommended by the manufacturer; n = 30). Patients will be assigned to either of the cohorts, based on their preferences.

Two laryngeal (posterior cricoid) biopsy specimens (one for pepsin ELISA and the other for qPCR for IL -1β, -6, and -8 inflammatory cytokines) and a throat saliva sample (for pepsin ELISA) will be obtained pre- and posttreatment (12 weeks) in an ambulatory clinic setting. The RSI, a patient-reported symptom severity questionnaire, will be administered in the clinic pre- and posttreatment. (36) Patients will be instructed to cough and clear the back of their throat to provide a saliva sample prior to endoscopy. The RFS (37) will be obtained by the study physicians during office endoscopy prior to biopsy. Deidentified biopsy and saliva samples will be transported to the research laboratory on ice and stored at -80 prior to analyses by ELISA and qPCR.

Pepsin ELISA One biopsy per subject will be homogenized in urea lysis buffer and total protein concentration determined as previously described (28). Saliva samples will be cleared by brief centrifugation. Noncompetitive indirect sandwich enzyme-linked immunosorbent assay described previously (35) will be performed to detect pepsin in biopsy homogenate and saliva.

qPCR RNA will be extracted from a second biopsy, DNAsed and reverse transcribed as described (38). Real time polymerase chain reaction will be performed in a Viaa7 Real Time PCR System using Taqman Gene Expression Assays targeting IL -1β, -6, and -8, and the housekeeping gene HPRT1 (ThermoFisher Scientific, Waltham, MA).

This pilot study will pave the way for clinical trials of a much-needed therapy for airway reflux. If the hypothesis proves true and the Reza Band resolves pepsin and inflammatory cytokines, and significantly improves endoscopic signs (RFS) and symptoms (RSI) of LPR, these data will also support a clinical trial to assess the utility of the Reza Band in preventing reflux-attributed laryngeal inflammatory and neoplastic disease sequelae. To our knowledge, this is the first study that will use pepsin as a primary outcome measure; it is believed to be a sensitive and specific biomarker for reflux and aspiration.

Deidentified biopsy and saliva samples will be transported to the research laboratory on ice and stored at -80 degrees C prior to analyses by ELISA and qPCR. The tissue and saliva samples will be labeled with patient study ID number and date of collection.

Being tested
Reza band
Medical subject headings
Laryngopharyngeal Reflux

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Reza bandDevice

    Reza band, a non-medication, non-surgical medical device designed to reduce symptoms of LPR has recently been approved by the FDA. It works by stopping the flow of gastric contents through the upper esophageal sphincter (UES) by increasing the internal pressure of the UES

Study groups in NCT03463395
Study groupRoleWhat they receive
Standard of CareNo interventionGroup A will receive standard of care
Reza band useExperimentalGroup B will receive standard care plus the Reza band (worn as recommended by the manufacturer)
Receives: Device: Reza band

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Tissue and Salivary Pepsin Levels

    The primary objective is to evaluate the efficacy of the Reza Band for the treatment of LPR. We propose a pilot clinical trial to test the hypothesis that the Reza Band is effective for the treatment of LPR, measured by resolution of pepsin and decrease to normative values for RSI, Reflux Finding Score (RFS) and inflammatory cytokines.

    Measured: The change in Pepsin will be measured pre and post 12 week treatment for LPR +/- Reza band

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Mar 2018
  2. Study startJul 2020 (estimated)
  3. Primary completionNov 2021 (estimated)
  4. Study completionNov 2021 (estimated)

Why it stopped: Funding for this study has ended and we were unable to enroll any subjects

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
Sixty patients ≥ 18 years of age presenting to the investigator's laryngology outpatient clinic with LPR, with an RFS ≥ 7 and an RSI ≥ 13, not on anticoagulants, able to tolerate an endoscopy and consent to participate in this research study will be included. One cohort (Group A) will receive standard care (n =30), the other (Group B) will receive standard care plus the Reza band (to be worn as recommended by the manufacturer; n = 30).
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03463395
Sponsor's protocol ID
PRO30948
Status last verified
May 2020
First submitted
5 Mar 2018
Last updated
8 May 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No: If the decision is made to make individual participant data (IPD) available to other researchers, that data will be completely identified prior to release.

Publications

  • Ford CN. Evaluation and management of laryngopharyngeal reflux. JAMA. 2005 Sep 28;294(12):1534-40. doi: 10.1001/jama.294.12.1534.

    PubMed 16189367
  • Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope. 1991 Apr;101(4 Pt 2 Suppl 53):1-78. doi: 10.1002/lary.1991.101.s53.1.

    PubMed 1895864
  • Vaezi MF. Extraesophageal manifestations of gastroesophageal reflux disease. Clin Cornerstone. 2003;5(4):32-8; discussion 39-40. doi: 10.1016/s1098-3597(03)90097-4.

    PubMed 15101493
  • GABRIEL CE, JONES DG. The importance of chronic laryngitis. J Laryngol Otol. 1960 Jun;74:349-57. doi: 10.1017/s0022215100056693. No abstract available.

    PubMed 13825824
  • Yudkin PL, Aboualfa M, Eyre JA, Redman CW, Wilkinson AR. New birthweight and head circumference centiles for gestational ages 24 to 42 weeks. Early Hum Dev. 1987 Jan;15(1):45-52. doi: 10.1016/0378-3782(87)90099-5.

    PubMed 3816638
  • Perrier D, Gibaldi M. Clearance and biologic half-life as indices of intrinsic hepatic metabolism. J Pharmacol Exp Ther. 1974 Oct;191(1):17-24. No abstract available.

    PubMed 4423599
  • Inokuchi K. [Prospectives on cancer treatment in the future--from its clinical aspects]. Gan To Kagaku Ryoho. 1987 May;14(5 Pt 2):1372-9. Japanese.

    PubMed 3109325
  • Wight R, Paleri V, Arullendran P. Current theories for the development of nonsmoking and nondrinking laryngeal carcinoma. Curr Opin Otolaryngol Head Neck Surg. 2003 Apr;11(2):73-7. doi: 10.1097/00020840-200304000-00002.

    PubMed 14515082
  • Koufman JA. Low-acid diet for recalcitrant laryngopharyngeal reflux: therapeutic benefits and their implications. Ann Otol Rhinol Laryngol. 2011 May;120(5):281-7. doi: 10.1177/000348941112000501.

    PubMed 21675582
  • Koufman JA, Amin MR, Panetti M. Prevalence of reflux in 113 consecutive patients with laryngeal and voice disorders. Otolaryngol Head Neck Surg. 2000 Oct;123(4):385-8. doi: 10.1067/mhn.2000.109935.

    PubMed 11020172
  • Reulbach TR, Belafsky PC, Blalock PD, Koufman JA, Postma GN. Occult laryngeal pathology in a community-based cohort. Otolaryngol Head Neck Surg. 2001 Apr;124(4):448-50. doi: 10.1067/mhn.2001.114256.

    PubMed 11283505
  • Francis DO, Rymer JA, Slaughter JC, Choksi Y, Jiramongkolchai P, Ogbeide E, Tran C, Goutte M, Garrett CG, Hagaman D, Vaezi MF. High economic burden of caring for patients with suspected extraesophageal reflux. Am J Gastroenterol. 2013 Jun;108(6):905-11. doi: 10.1038/ajg.2013.69. Epub 2013 Apr 2.

    PubMed 23545710
  • Szczesniak MM, Williams RB, Brake HM, Maclean JC, Cole IE, Cook IJ. Upregulation of the esophago-UES relaxation response: a possible pathophysiological mechanism in suspected reflux laryngitis. Neurogastroenterol Motil. 2010 Apr;22(4):381-6, e89. doi: 10.1111/j.1365-2982.2009.01452.x.

    PubMed 20377793
  • Huszenicza G, Haraszti J, Molnar L, Solti L, Fekete S, Ekes K, Yaro AC. Some metabolic characteristics of dairy cows with different post partum ovarian function. Zentralbl Veterinarmed A. 1988 Aug;35(7):506-15. No abstract available.

    PubMed 3142175
  • Torrico S, Kern M, Aslam M, Narayanan S, Kannappan A, Ren J, Sui Z, Hofmann C, Shaker R. Upper esophageal sphincter function during gastroesophageal reflux events revisited. Am J Physiol Gastrointest Liver Physiol. 2000 Aug;279(2):G262-7. doi: 10.1152/ajpgi.2000.279.2.G262.

    PubMed 10915633

Questions about this trial

What is this clinical trial studying?

A study testing Reza band in people with Laryngopharyngeal Reflux, run by Medical College of Wisconsin at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 8 May 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Tissue and Salivary Pepsin Levels (time frame: The change in Pepsin will be measured pre and post 12 week treatment for LPR +/- Reza band). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03463395, which also lists 30 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 May 2020.

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