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GERDROSENCT03705416

Long Term Outcomes of Bariatric Patients Treated With Surgery or Endoscopy

An observational study of GERD and Obesity, run by Johns Hopkins University at 6 sites in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

GERD is common in the obese population. Bariatric procedures are the mainstay of therapy for these patients. Bariatric procedures can be surgical (Roux-en-Y gastric bypass and Vertical sleeve gastrectomy) or endoscopic (endoscopic sleeve gastroplasty). Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
GERD, Obesity
What is being tested?
Endoscopy and Surgery
Type of treatment
Surgery or procedure
How many people
250 participants
Where
6 sitesUnited States
Study dates
30 Mar 2019to 30 Mar 2028
Phase
Observational
Are there results?
Not yet: the study is under way

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 to 75 years
  • All sexes
  • Adult, Older adult

Study population: Obese patients with BMI 30 scheduled to undergo a bariatric interventions (endoscopic and surgical) at multiple academic medical centers in the United States offering both treatments.

Who may be able to join

  • BMI ≥ 30 Kg/m2
  • Patients scheduled to undergo a bariatric weight loss procedure (endoscopic or surgical)
  • Patients older than 18 years and younger than 75 years of age at time of consent
  • Patients able to provide written informed consent on the Institutional review board (IRB) approved informed consent form
  • Patients willing and able to comply with study requirements for follow-up

Who cannot join

  • Any patient with BMI < 30 Kg/m2
  • Patients treated with intragastric balloons.
  • Pre-existing esophageal stenosis/stricture preventing advancement of an endoscope during screening/baseline Esophagogastroduodenoscopy (EGD)
  • Esophageal, gastric or duodenal malignancy
  • Severe medical comorbidities precluding endoscopy, or limiting life expectancy to less than 2 years in the judgment of the endoscopist
  • Uncontrolled coagulopathy or inability to be off anticoagulation or anti-platelet medication (ASA, Plavix) for 1 week prior to and 2 weeks after each endoscopy
Show all 13Show fewer
  • Active fungal esophagitis
  • Known portal hypertension, visible esophageal or gastric varices, or history of esophageal varices
  • General poor health, multiple co-morbidities placing the patient at risk, or otherwise unsuitable for trial participation
  • Pregnant or planning to become pregnant during period of study participation
  • Patient refuses or is unable to provide written informed consent
  • Prior bariatric treatment procedure
  • Prior surgical or endoscopic anti-reflux procedure

Trial locations and contacts

6 sites in 1 country.

6 sites in 1 country

United States6 sites
  • Johns Hopkins University

    Baltimore, Maryland, 21287

  • Memorial Hermann Health System

    Houston, Texas, 77401

  • Northwell Health

    New Hyde Park, New York, 11040

  • Weill Cornell

    New York, New York, 10021

  • Legacy Oregon Clinic

    Portland, Oregon, 97213

  • Utah-Health: University of Utah

    Salt Lake City, Utah, 84132

Other trials in United States

About this study

Official title: Reflux in the Obese Undergoing Surgery or Endoscopy (ROSE) Previously: Gastroesophageal Reflux Disease (GERD) in Bariatric Patients

GERD is common in the obese population. Bariatric procedures are the mainstay of therapy for these patients. Bariatric procedures can be surgical (Roux-en-Y gastric bypass and Vertical sleeve gastrectomy) or endoscopic (endoscopic sleeve gastroplasty). The rate of GERD after either treatment is unknown as is the rate of silent reflux. The study primary objective is to assess the incidence rate of GERD in bariatric patients that undergo either therapy.

Read the detailed description

GERD is a prevalent condition worldwide, estimated to be around 20-30 % in North America. Obesity is rapidly increasing with an estimated prevalence of 66% in the adult population in the United States. GERD symptoms are common in the obese population with data showing weekly GERD symptoms in 34.6% and erosive esophagitis 26.9% in people with BMI > 30 Kg/m2.

Presently, bariatric procedures are the only sustainable method to address morbid obesity and its resulting comorbidities. There are endoscopic and surgical bariatric procedures. The natural history of GERD symptoms in this population after undergoing a bariatric treatment is scarce or conflicting. Moreover, silent or asymptomatic GERD prevalence has not been well established preoperatively. Evaluation and documentation of GERD may potentially change the planned bariatric procedure and avoid unnecessary additional surgeries or procedures to address symptomatic post-operative GERD.

The investigators hypothesized that GERD is more prevalent in patients undergoing surgical bariatric procedures, specifically laparoscopic vertical sleeve gastrectomy (VSG). This multi-center, prospective, cohort study can potentially clarify current debatable data, based mostly on retrospective studies, and can help clinicians to select the most appropriate bariatric treatment for the patients. Most importantly, by selecting the best approach based on preoperative GERD studies it could prevent long term complications of GERD and further unnecessary procedures for the bariatric patient.

Conditions
GERD, Obesity
Being tested
Endoscopy, Surgery
Keywords
GERD, Bariatric surgery, Endoscopic sleeve gastroplasty, Sleeve gastrectomy, Roux-en-Y gastric bypass
Medical subject headings
Gastroesophageal Reflux, Obesity

What participants receive

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

  • EndoscopyProcedure or surgery

    Also called Endoscopic sleeve gastroplasty or ESG

    endoscopic suturing of stomach

  • SurgeryProcedure or surgery

    Also called Surgical reduction or bypass

    Vertical sleeve gastrectomy (VSG) surgical reduction of stomach, or (RYGBP) , or gastric bypass procedure

Study groups in NCT03705416
Study groupRoleWhat they receive
Endoscopic sleeve gastroplastyAll obese patients who will be undergoing an endoscopic sleeve gastroplasty (ESG). As part of the standard of care this patients will have a preoperative gastroscopy with wireless pH monitoring. Then after the endoscopic sleeve gastroplasty patients will be followed up regarding GERD symptoms for 5 years. As part of the standard of care a follow up endoscopy will be done at year 1 and wireless pH monitoring will be performed
Receives: Procedure: Endoscopy
Surgery (VSG or RYGBP)All obese patients who will be undergoing either a vertical sleeve gastrectomy or a Roux-en-Y gastric bypass. As part of the standard of care this patients will have a preoperative gastroscopy with wireless pH monitoring. Then after the surgical procedure patients will be followed up regarding GERD symptoms for 5 years. As part of the standard of care a follow up endoscopy will be done at year 1 and wireless pH monitoring will be performed
Receives: Procedure: Surgery

What is being measured

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

  1. Percentage of participants with GERD based on symptoms, and abnormal acid exposure time and/or reflux esophagitis

    GERD symptoms, esophageal acid exposure time and/or esophagitis

    Measured: 1 year

Secondary outcomes (9)
  1. Difference in BMI after the bariatric procedure

    change in weight in Kg and height in m (BMI=Kg/m) before and after treatment

    Measured: 5 years

  2. Reflux esophagitis

    Incidence of GERD-related complications

    Measured: 5 years

  3. GERD severity based on standardized Reflux Disease Questionnaire (RDQ)

    GERD severity based on standardized Reflux Disease Questionnaire (RDQ) questionnaire (score 12-72; the greater the score, the greater the severity)

    Measured: 3,6,12,24,26,48, and 60 months post procedure

  4. GERD severity as assessed by GERD-Health related quality of life (HRQL) score

    GERD-Health related quality of life (HRQL) score (score 0-53; the greater the score,the worse the quality of life) will be used for this assessment

    Measured: 3,6,12,24,26,48, and 60 months post procedure

  5. Percentage of participants on daily or twice daily PPI for GERD symptoms control, regardless of pH-monitoring results

    Proportion of patients being treated with medication (PPI)

    Measured: 5 years

  6. Percent of patients with abnormal esophageal acid exposure time > 6% defined by Bravo pH monitoring (96 hours)

    Abnormal esophageal acid exposure time (AET)

    Measured: 1 year

  7. Percentage of excess body weight (EBW) loss and total body weight loss (TBWL)

    Change in body weight after treatment with endoscopy and surgery (compare groups)

    Measured: 5 years

  8. Prevalence and incidence of silent reflux

    Proportion of patients with abnormal AET without symptoms after bariatric treatment procedure

    Measured: 1 year

  9. Percentage of patients with GERD at baseline in whom the planned bariatric intervention was changed due to abnormal ph testing or presence of erosive esophagitis, Barrett's esophagus, reflux related esophageal stricture

    Proportion of patients with change in treatment plan after diagnostic evaluation

    Measured: 1 year

Timeline

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

  1. First posted15 Oct 2018
  2. Study start30 Mar 2019
  3. Primary completionDec 2026 (estimated)
  4. Study completion30 Mar 2028 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
250 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03705416
Sponsor's protocol ID
IRB00186052
Other IDs
The ROSE study
Acronym
ROSE
Status last verified
Aug 2026
First submitted
21 Sep 2018
Last updated
21 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Research projects will be submitted to host (currently JHU) and accepted project will be granted access to read only de-identified database.

Publications

  • Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R; Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006 Aug;101(8):1900-20; quiz 1943. doi: 10.1111/j.1572-0241.2006.00630.x.

    PubMed 16928254
  • Tutuian R. Obesity and GERD: pathophysiology and effect of bariatric surgery. Curr Gastroenterol Rep. 2011 Jun;13(3):205-12. doi: 10.1007/s11894-011-0191-y.

    PubMed 21424733
  • Singh M, Lee J, Gupta N, Gaddam S, Smith BK, Wani SB, Sullivan DK, Rastogi A, Bansal A, Donnelly JE, Sharma P. Weight loss can lead to resolution of gastroesophageal reflux disease symptoms: a prospective intervention trial. Obesity (Silver Spring). 2013 Feb;21(2):284-90. doi: 10.1002/oby.20279.

    PubMed 23532991
  • Borbely Y, Schaffner E, Zimmermann L, Huguenin M, Plitzko G, Nett P, Kroll D. De novo gastroesophageal reflux disease after sleeve gastrectomy: role of preoperative silent reflux. Surg Endosc. 2019 Mar;33(3):789-793. doi: 10.1007/s00464-018-6344-4. Epub 2018 Jul 12.

    PubMed 30003346
  • El-Serag HB, Graham DY, Satia JA, Rabeneck L. Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol. 2005 Jun;100(6):1243-50. doi: 10.1111/j.1572-0241.2005.41703.x.

    PubMed 15929752
  • Kurian M, Kroh M, Chand B, Mikami D, Reavis K, Khaitan L. SAGES review of endoscopic and minimally invasive bariatric interventions: a review of endoscopic and non-surgical bariatric interventions. Surg Endosc. 2018 Oct;32(10):4063-4067. doi: 10.1007/s00464-018-6238-5. Epub 2018 May 29.

    PubMed 29845397
  • Chung AY, Thompson R, Overby DW, Duke MC, Farrell TM. Sleeve Gastrectomy: Surgical Tips. J Laparoendosc Adv Surg Tech A. 2018 Aug;28(8):930-937. doi: 10.1089/lap.2018.0392. Epub 2018 Jul 13.

    PubMed 30004814
  • Schlottmann F, Buxhoeveden R. Laparoscopic Roux-en-Y Gastric Bypass: Surgical Technique and Tips for Success. J Laparoendosc Adv Surg Tech A. 2018 Aug;28(8):938-943. doi: 10.1089/lap.2018.0393. Epub 2018 Jul 16.

    PubMed 30010475
  • Rebecchi F, Allaix ME, Giaccone C, Ugliono E, Scozzari G, Morino M. Gastroesophageal reflux disease and laparoscopic sleeve gastrectomy: a physiopathologic evaluation. Ann Surg. 2014 Nov;260(5):909-14; discussion 914-5. doi: 10.1097/SLA.0000000000000967.

    PubMed 25379861
  • Burgerhart JS, Schotborgh CA, Schoon EJ, Smulders JF, van de Meeberg PC, Siersema PD, Smout AJ. Effect of sleeve gastrectomy on gastroesophageal reflux. Obes Surg. 2014 Sep;24(9):1436-41. doi: 10.1007/s11695-014-1222-1.

    PubMed 24619293
  • Oor JE, Roks DJ, Unlu C, Hazebroek EJ. Laparoscopic sleeve gastrectomy and gastroesophageal reflux disease: a systematic review and meta-analysis. Am J Surg. 2016 Jan;211(1):250-67. doi: 10.1016/j.amjsurg.2015.05.031. Epub 2015 Aug 14.

    PubMed 26341463

Questions about this trial

What is this clinical trial studying?

An observational study of GERD and Obesity, run by Johns Hopkins University at 6 sites 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 5 inclusion and 13 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: under way, not looking for participants, as of the sponsor's last update on 21 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites 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?

This study is still under way. Results are not available in the source record yet.

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?

Percentage of participants with GERD based on symptoms, and abnormal acid exposure time and/or reflux esophagitis (time frame: 1 year). 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 NCT03705416, which also lists 11 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 21 Aug 2026.

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