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Morbid ObesityNROT1NCT05420506

Nonsurgical Reversible Obesity Treatment (NROT1)

A study testing NROT1 in people with Morbid Obesity, run by Yeditepe University.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The present study relates to apparatus and methods that can be applied using non-invasive techniques for effectively reducing nutrient absorption in the small intestines of obese people. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Morbid Obesity
What is being tested?
NROT1
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
No sites listed yet
Study dates
Dec 2022to Jun 2024
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 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnosis of morbid obesity
  • Age limits: 18-65 years
  • No history of gastrointestinal surgery
  • Agreement for voluntary participation in the study

Who cannot join

  • Presence of obesity that is not at the morbid level
  • Those who do not accept to participate in the study
  • Those who have an obstacle to endoscopic intervention
  • Presence of a history of gastrointestinal surgery

Trial locations and contacts

No sites are listed yet.

About this study

Official title: Treatment of Obesity Without Surgical Intervention by Reversible Reduction of the Small Intestinal Absorption Area

The present study relates to apparatus and methods that can be applied using non-invasive techniques for effectively reducing nutrient absorption in the small intestines of obese people.

Read the detailed description

Obesity is a worldwide health problem which may be further worsened by global Corona virus (COVID-19) pandemic. It may cause social, psychological disorders and chronic diseases such as diabetes and cardiac problems.

Surgical and existing non-surgical (e.g., intragastric balloon placement) procedures are well established procedures to cope with the morbid obesity problem. The principle of using these procedures is based on reducing the surface area available for absorption in the stomach or in small intestine, so that weight loss is gradually accomplished.

Recent bariatric surgery procedures (a more complete description of which can be found for example on the website of the American Society for Bariatric Surgery at http://www.asbs.org) involve alteration of a patient's digestive tract including various reversible and malabsorptive bypass procedures such as jejuno-ileal bypass, gastric bypass and Roux-en-Y gastric bypass, or by irreversible gastric sleeve (restrictive) procedures.

In non-surgical intragastric balloon (IGB) placement procedures, the volume of the space occupying device (balloon) prevents the ingestion of food into the stomach, reducing the desire for food.

Most known complications of IGBs are nausea, vomiting, and discomfort, during and/or shortly after their insertion and removal. Blockage risk of the exit of the stomach (pylori) due to squeezing-pushing action of the stomach is another issue with IGBs.

On April 27, 2020, the U.S. Food and Drug Administration (FDA) released an update on the potential risks of over-inflation (spontaneous hyperinflation), acute pancreatitis, and deaths in patients with some liquid-filled IGBs. Hyperinflation involves the spontaneous filling of IGBs with additional air or liquid while the balloon is in the stomach, this usually requires IGB removal. On the other hand, the mechanism of acute pancreatitis development could be related to pressure from the IGB and distended stomach causing direct injury to the pancreatic parenchyma, compression of the pancreatic duct, and/or indirect pancreatic injury through duodenal obstruction.

All of these critical observations mentioned above show that there is a need for a transorally placed device which can be easily inserted into and removed from the gastrointestinal tract, does not migrate, minimize complications, well tolerated and less costly.

The present study aims to provide a gastrointestinal implant device which includes a solid part for placement into a small intestine so that it reduces absorption of nutrients and particularly fats through the small intestine. This can be more effective weight losing procedure than IGB application alone in stomach, as nutrients and fat intake can be reduced using intestinal implant device.

Transorally placed implant device can be easily inserted into and removed from the gastrointestinal tract, does not migrate, and costs less.

While existing non-surgical weight losing devices induce satiation, hence reduce the frequency and amount of eating, present invention does not limit them, since the operational principle of the present study is neither based on a space occupying type nor a sleeve type implant.

SCIENTIFIC BACKGROUND

  1. All orally ingested foods with caloric value are absorbed from the small intestine, and especially from the proximal small intestine, then pass into the blood. Colon provides only the absorption of fluid and electrolytes.
  2. As the length of the small intestine is shortened, the intestinal absorption area for the foods with caloric value will decrease, so even if the patient continues to eat, he or she does not gain weight, on the contrary, he or she loses weight.
  3. When the orally ingested foods pass through the stomach and duodenum and then enter into the small intestine, they are pushed from proximal to distal intestine by segmental contraction and relaxation movements called peristaltic movements. During these movements, if the food remains stable or stuck in a certain intestinal region, the small intestine segments gather into the proximal region of the intestine and try to push the food to distal end of small intestine by making more severe peristaltic movements. Meanwhile, the length of the small intestine shortens, hence the overall small intestinal absorption area decreases.

Based on this fundamental physiological information, in this study, implant piece placed into the small intestine is anchored either in the stomach or in the oral cavity (dental anchoring) with a biocompatible thread, and the small intestine segments are accumulated in the proximal end of the small intestine in the manner of an accordion in the region where implant device is floating, hence shortening its length and reducing the overall small intestinal absorption area.

Conditions
Morbid Obesity
Being tested
NROT1
Keywords
obesity treatment, non-surgical, small intestine, reversible
Medical subject headings
Obesity, Morbid

What participants receive

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

  • NROT1Device

    Dental anchored intestinal placement of obesity treatment device with endoscopic intervention

Study groups in NCT05420506
Study groupRoleWhat they receive
NROT1ExperimentalIntestinal device placement in subjects and their follow up
Receives: Device: NROT1

What is being measured

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

  1. Change of weight in subjects after 6 Months of intestinal device placement

    The weight of each subject will be measured and recorded at the time of intestinal device placement and after 6 months of the placement. Then, statistical analysis will be carried out.

    Measured: 6 months

Timeline

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

  1. First posted15 Jun 2022
  2. Study startDec 2022 (estimated)
  3. Primary completionDec 2023 (estimated)
  4. Study completionJun 2024 (estimated)

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
Not applicable
Intervention model
Sequential
Masking
None (open label)
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05420506
Sponsor's protocol ID
1005
Acronym
NROT1
Status last verified
Jun 2022
First submitted
10 Jun 2022
Last updated
22 Jun 2022
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NM, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nonato IC, Chang JC, Chowdhury R, Courville KJ, Criqui MH, Cundiff DK, Dabhadkar KC, Dandona L, Davis A, Dayama A, Dharmaratne SD, Ding EL, Durrani AM, Esteghamati A, Farzadfar F, Fay DF, Feigin VL, Flaxman A, Forouzanfar MH, Goto A, Green MA, Gupta R, Hafezi-Nejad N, Hankey GJ, Harewood HC, Havmoeller R, Hay S, Hernandez L, Husseini A, Idrisov BT, Ikeda N, Islami F, Jahangir E, Jassal SK, Jee SH, Jeffreys M, Jonas JB, Kabagambe EK, Khalifa SE, Kengne AP, Khader YS, Khang YH, Kim D, Kimokoti RW, Kinge JM, Kokubo Y, Kosen S, Kwan G, Lai T, Leinsalu M, Li Y, Liang X, Liu S, Logroscino G, Lotufo PA, Lu Y, Ma J, Mainoo NK, Mensah GA, Merriman TR, Mokdad AH, Moschandreas J, Naghavi M, Naheed A, Nand D, Narayan KM, Nelson EL, Neuhouser ML, Nisar MI, Ohkubo T, Oti SO, Pedroza A, Prabhakaran D, Roy N, Sampson U, Seo H, Sepanlou SG, Shibuya K, Shiri R, Shiue I, Singh GM, Singh JA, Skirbekk V, Stapelberg NJ, Sturua L, Sykes BL, Tobias M, Tran BX, Trasande L, Toyoshima H, van de Vijver S, Vasankari TJ, Veerman JL, Velasquez-Melendez G, Vlassov VV, Vollset SE, Vos T, Wang C, Wang X, Weiderpass E, Werdecker A, Wright JL, Yang YC, Yatsuya H, Yoon J, Yoon SJ, Zhao Y, Zhou M, Zhu S, Lopez AD, Murray CJ, Gakidou E. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014 Aug 30;384(9945):766-81. doi: 10.1016/S0140-6736(14)60460-8. Epub 2014 May 29.

    PubMed 24880830
  • Daniel S, Soleymani T, Garvey WT. A complications-based clinical staging of obesity to guide treatment modality and intensity. Curr Opin Endocrinol Diabetes Obes. 2013 Oct;20(5):377-88. doi: 10.1097/01.med.0000433067.01671.f5.

    PubMed 23974764
  • Nguyen NT, Vu S, Kim E, Bodunova N, Phelan MJ. Trends in utilization of bariatric surgery, 2009-2012. Surg Endosc. 2016 Jul;30(7):2723-7. doi: 10.1007/s00464-015-4535-9. Epub 2015 Dec 10.

    PubMed 26659240
  • Vargas EJ, Rizk M, Bazerbachi F, Abu Dayyeh BK. Medical Devices for Obesity Treatment: Endoscopic Bariatric Therapies. Med Clin North Am. 2018 Jan;102(1):149-163. doi: 10.1016/j.mcna.2017.08.013.

    PubMed 29156183
  • Sullivan S, Edmundowicz SA, Thompson CC. Endoscopic Bariatric and Metabolic Therapies: New and Emerging Technologies. Gastroenterology. 2017 May;152(7):1791-1801. doi: 10.1053/j.gastro.2017.01.044. Epub 2017 Feb 10.

    PubMed 28192103
  • Nieben OG, Harboe H. Intragastric balloon as an artificial bezoar for treatment of obesity. Lancet. 1982 Jan 23;1(8265):198-9. doi: 10.1016/s0140-6736(82)90762-0.

    PubMed 6119560
  • Stimac D, Klobucar Majanovic S, Belancic A. Endoscopic Treatment of Obesity: From Past to Future. Dig Dis. 2020 Jan 6:1-13. doi: 10.1159/000505394. Online ahead of print.

    PubMed 31905356
  • Kral J, Machytka E, Horka V, Selucka J, Dolecek F, Spicak J, Kovarova V, Haluzik M, Buzga M. Endoscopic Treatment of Obesity and Nutritional Aspects of Bariatric Endoscopy. Nutrients. 2021 Nov 26;13(12):4268. doi: 10.3390/nu13124268.

    PubMed 34959819
  • Chiang AL, Ryou M. Endoscopic treatment of obesity. Curr Opin Gastroenterol. 2016 Nov;32(6):487-491. doi: 10.1097/MOG.0000000000000307.

    PubMed 27607342
  • Swidnicka-Siergiejko A, Wroblewski E, Andrzej D. Endoscopic treatment of obesity. Can J Gastroenterol. 2011 Nov;25(11):627-33. doi: 10.1155/2011/174163.

    PubMed 22059171
  • Familiari P, Boskoski I, Marchese M, Perri V, Costamagna G. Endoscopic treatment of obesity. Expert Rev Gastroenterol Hepatol. 2011 Dec;5(6):689-701. doi: 10.1586/egh.11.77.

    PubMed 22017697
  • Lee HL. Role of Restrictive Endoscopic Procedures in Obesity Treatment. Clin Endosc. 2017 Jan;50(1):17-20. doi: 10.5946/ce.2017.022. Epub 2017 Jan 30.

    PubMed 28147476
  • Park JM. Role of Malabsorptive Endoscopic Procedures in Obesity Treatment. Clin Endosc. 2017 Jan;50(1):26-30. doi: 10.5946/ce.2017.004. Epub 2017 Jan 30.

    PubMed 28147470
  • Hurt RT, Frazier TH, Mundi MS. Novel Nonsurgical Endoscopic Approaches for the Treatment of Obesity. Nutr Clin Pract. 2017 Aug;32(4):493-501. doi: 10.1177/0884533617714235. Epub 2017 Jun 16.

    PubMed 28622478
  • Espinet-Coll E, Nebreda-Duran J, Gomez-Valero JA, Munoz-Navas M, Pujol-Gebelli J, Vila-Lolo C, Martinez-Gomez A, Juan-Creix-Comamala A. Current endoscopic techniques in the treatment of obesity. Rev Esp Enferm Dig. 2012 Feb;104(2):72-87. doi: 10.4321/s1130-01082012000200006.

    PubMed 22372801

Questions about this trial

What is this clinical trial studying?

A study testing NROT1 in people with Morbid Obesity, run by Yeditepe University.

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 4 inclusion and 4 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: status not confirmed, as of the sponsor's last update on 22 Jun 2022. Status can change between updates, so confirm with the study contact before making plans.

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?

Results are not available in the source record.

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

Contact Erhan Aysan, M.D. (+90 2165780000 ext. 5480, erhanaysan@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change of weight in subjects after 6 Months of intestinal device placement (time frame: 6 months). 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 NCT05420506, which also lists 28 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 22 Jun 2022.

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