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ObesityAW2NCT05992103

ABLATE WEIGHT 2 (Single-Stage Fundic Ablation Plus ESG for Weight Loss)

A study testing Fundic Ablation in Combination with Endoscopic Sleeve Gastroplasty, Fundic Mucosal Ablation with ERBE HybridAPC and Apollo ESG in people with Obesity, run by True You Weight Loss at 1 site in United States.

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 The sponsor has not verified this record for over two years, so it may be out of date.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 purpose of this research is to investigate the combined effects of fundic ablation (FA) and endoscopic sleeve gastroplasty on circulating plasma ghrelin, satiation, and total body weight loss, as well as the incidence of adverse events. Read more about this study

Who is it for?
Ages 21 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Obesity
What is being tested?
Fundic Ablation in Combination with Endoscopic Sleeve Gastroplasty, Fundic Mucosal Ablation with ERBE HybridAPC and Apollo ESG
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
1 siteUnited States
Study dates
14 Sep 2023to 15 May 2025
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 21 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Subjects aged 21-65
  • Body mass Index (BMI) ≥30 kilograms per square meter (kg/m²), or ≤50 kg/m²
  • History of at least one unsuccessful dietary effort to lose body weight
  • Willing and able to participate in the study procedures
  • Understand and voluntarily sign the informed consent
  • Approved ESG candidate at True You Weight Loss
  • Access to internet
  • Reliable transportation to and from Cary, North Carolina surrounding area

Who cannot join

  • Younger than 21 years of age
  • Older than 65 years of age
  • Patients on any medications or supplements including those that may influence cholecystokinin (CCK), glucose, growth hormone, insulin and/or somatostatin levels
  • Milk and/or soy allergies
  • History of any stomach manipulation (including repair of hiatal hernia)
  • History of disordered eating
Show all 15Show fewer
  • Patients who do not give their consent to the enrollment in the study or are incompetent, unconscious or unable to express their consent for any reason
  • Hemoglobin A1c > 7.0 or any patient with symptoms suggestive of gastroparesis or a formal diagnosis of gastroparesis
  • Patients taking the following medications known to impair gastric accommodation: buspirone, mirtazapine
  • Patients taking the following medications known to accelerate or impair gastric emptying: Reglan (metoclopramide), Zelnorm (tegaserod), Motegrity (prucalopride), erythromycin, Motilium (domperidone), opiates, anticholinergic agents
  • Patients who are pregnant or who plan to become pregnant during study duration
  • Use of non-steroidal anti-inflammatory medications without the ability to stop these during study duration
  • Patients on chronic anticoagulation
  • History of functional gastrointestinal disorder, including functional dyspepsia, irritable bowel syndrome, or other syndromes known to affect gastric sensorimotor function.
  • Concurrent use of weight loss medications.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • True You Weight Loss

    Cary, North Carolina, 27513

Other trials in United States

About this study

Official title: Single-Stage Gastric Fundus Ablation and Endoscopic Sleeve Gastroplasty for Weight Loss

The purpose of this research is to investigate the combined effects of fundic ablation (FA) and endoscopic sleeve gastroplasty on circulating plasma ghrelin, satiation, and total body weight loss, as well as the incidence of adverse events. This procedure will be carried out with the HybridAPC (ERBE Elektromedizin GmbH, Tübingen, Germany). The HybridAPC instrument creates an electric current to deliver a safe amount of thermal injury to a portion of the stomach known as the gastric fundus. This thermal injury will target a hormone called ghrelin which is the only known hormone linked to increasing appetite, calorie intake, and weight gain. This procedure is designed to target the bodily effects of appetite control and gastric sensory and motor functions which cause the feeling of fullness and satiation. When fundic mucosal ablation is paired with endoscopic sleeve gastroplasty (ESG), this combined investigational approach may lead to decreased fasting ghrelin levels, improved satiation, and greater total body weight loss than traditional ESG. This study will help determine if the combined impact of FA with ESG within the same endoscopic session should be made available to patients as part of a comprehensive weight loss strategy.

Read the detailed description

Obesity is a chronic disease state driven by the imbalance of caloric intake and expenditure and mediated by multiple central and peripheral pathways that may serve as targets for therapeutic interventions. The endoscopic sleeve gastroplasty (ESG) is a per oral gastric remodeling technique that employs full-thickness suturing to imbricate the stomach along the greater curvature to achieve a restricted, sleeve-like configuration. While the ESG recapitulates the configuration of a gastric sleeve, it has not yet been shown to achieve as robust weight loss outcomes compared to the laparoscopic sleeve gastrectomy (LSG). A major difference between ESG and LSG is that the former does not involve the gastric fundus. The proximal stomach, and the fundus in particular, produces ghrelin, the only known orexigenic hormone, which has been linked to increased calorie intake and weight gain. Studies have observed reduced levels of ghrelin along multiple timepoints following LSG, and this has been attributed to targeting of the fundus, as bariatric surgeries that did not involve the fundus did not see a decrease in circulating plasma ghrelin. In contrast, in a small comparative study of ESG and LSG, patients who had undergone ESG did not show any decrease in fasting ghrelin levels, 8 ostensibly due to fundic-sparing. In this study, the investigators propose to investigate the effects of fundic ablation (FA-ESG) on total body weight loss (TBWL) as well as the incidence of adverse events. Fundic ablation will be followed with ESG, to evaluate the combined impact of FA and ESG (FA-ESG). This study hypothesizes that the combined endoscopic intervention (FA-ESG) will result in significant weight loss while maintaining an acceptable safety profile

Conditions
Obesity
Being tested
Fundic Ablation in Combination with Endoscopic Sleeve Gastroplasty, Fundic Mucosal Ablation with ERBE HybridAPC, Apollo ESG
Medical subject headings
Obesity

What participants receive

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

  • Fundic Ablation in Combination with Endoscopic Sleeve GastroplastyProcedure or surgery

    Fundic mucosal ablation followed by endoscopic sleeve gastroplasty in the treatment of adults with obesity

  • Fundic Mucosal Ablation with ERBE HybridAPCDevice

    Fundic mucosal ablation utilizing approved ERBE HybridAPC

  • Apollo ESGDevice

    Using only Apollo ESG as approved per label

Study groups in NCT05992103
Study groupRoleWhat they receive
Single-Stage Gastric Fundic Ablation plus Endoscopic Sleeve GastroplastyExperimentalSubjects will undergo fundic mucosal ablation followed by endoscopic sleeve gastroplasty in the same endoscopic session
Receives: Procedure: Fundic Ablation in Combination with Endoscopic Sleeve Gastroplasty; Device: Fundic Mucosal Ablation with ERBE HybridAPC; Device: Apollo ESG

What is being measured

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

  1. Rate of Safety Complications

    Occurrence of Grade III - V complications according to the Clavien-Dindo classification

    Measured: Week 1, Month 1, Month 2, Month 3, Month 4, Month 6, Month 7, Month 8, Month 9, Month 10, Month 11, Month 12

  2. Rate of Adverse Events

    Occurrence of Adverse Events and Serious Adverse Events

    Measured: Week 1, Month 1, Month 2, Month 3, Month 4, Month 6, Month 7, Month 8, Month 9, Month 10, Month 11, Month 12

Secondary outcomes (1)
  1. Percent Change in Total Body Weight Loss (TBWL) from Baseline

    Measure percent change in total body weight over time following FA-ESG. TBWL = pre-op weight - post op body weight. % TBWL is the fraction of body weight expressed in percentage term

    Measured: Week 1, Month 1, Month 2, Month 3, Month 4, Month 6, Month 7, Month 8, Month 9, Month 10, Month 11, Month 12

Timeline

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

  1. First posted15 Aug 2023
  2. Study start14 Sep 2023
  3. Primary completion14 Apr 2025 (estimated)
  4. Study completion15 May 2025 (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
Single group
Masking
None (open label)
Enrolment
10 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05992103
Sponsor's protocol ID
PS-002
Acronym
AW2
Status last verified
Dec 2023
First submitted
8 Aug 2023
Last updated
7 Dec 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes

Publications

  • Fukunishi Y. [Electron microscopic findings in peripheral nerve lesions of nude mouse inoculated with M. leprae--perineural lesion]. Nihon Rai Gakkai Zasshi. 1985 Jul-Sep;54(3):82-7. doi: 10.5025/hansen1977.54.82. No abstract available. Japanese.

    PubMed 3915747
  • Cummings DE, Overduin J. Gastrointestinal regulation of food intake. J Clin Invest. 2007 Jan;117(1):13-23. doi: 10.1172/JCI30227.

    PubMed 17200702
  • Goitein D, Lederfein D, Tzioni R, Berkenstadt H, Venturero M, Rubin M. Mapping of ghrelin gene expression and cell distribution in the stomach of morbidly obese patients--a possible guide for efficient sleeve gastrectomy construction. Obes Surg. 2012 Apr;22(4):617-22. doi: 10.1007/s11695-011-0585-9.

    PubMed 22231739
  • Anderson B, Switzer NJ, Almamar A, Shi X, Birch DW, Karmali S. The impact of laparoscopic sleeve gastrectomy on plasma ghrelin levels: a systematic review. Obes Surg. 2013 Sep;23(9):1476-80. doi: 10.1007/s11695-013-0999-7.

    PubMed 23794092
  • McCarty TR, Jirapinyo P, Thompson CC. Effect of Sleeve Gastrectomy on Ghrelin, GLP-1, PYY, and GIP Gut Hormones: A Systematic Review and Meta-analysis. Ann Surg. 2020 Jul;272(1):72-80. doi: 10.1097/SLA.0000000000003614.

    PubMed 31592891
  • Langer FB, Reza Hoda MA, Bohdjalian A, Felberbauer FX, Zacherl J, Wenzl E, Schindler K, Luger A, Ludvik B, Prager G. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005 Aug;15(7):1024-9. doi: 10.1381/0960892054621125.

    PubMed 16105401
  • Lopez-Nava G, Negi A, Bautista-Castano I, Rubio MA, Asokkumar R. Gut and Metabolic Hormones Changes After Endoscopic Sleeve Gastroplasty (ESG) Vs. Laparoscopic Sleeve Gastrectomy (LSG). Obes Surg. 2020 Jul;30(7):2642-2651. doi: 10.1007/s11695-020-04541-0.

    PubMed 32193741
  • Vijayvargiya P, Chedid V, Wang XJ, Atieh J, Maselli D, Burton DD, Clark MM, Acosta A, Camilleri M. Associations of gastric volumes, ingestive behavior, calorie and volume intake, and fullness in obesity. Am J Physiol Gastrointest Liver Physiol. 2020 Aug 1;319(2):G238-G244. doi: 10.1152/ajpgi.00140.2020. Epub 2020 Jul 6.

    PubMed 32628074
  • Fayad L, Oberbach A, Schweitzer M, Askin F, Voltaggio L, Larman T, Enderle M, Hahn H, Khashab MA, Kalloo AN, Kumbhari V. Gastric mucosal devitalization (GMD): translation to a novel endoscopic metabolic therapy. Endosc Int Open. 2019 Dec;7(12):E1640-E1645. doi: 10.1055/a-0957-3067. Epub 2019 Nov 25.

    PubMed 31788546
  • Lopez Nava G, Arau RT, Asokkumar R, Maselli DB, Rapaka B, Matar R, Bautista I, Espinos Perez JC, Bilbao AM, Jaruvongvanich V, Vargas EJ, Storm AC, Neto MG, Abu Dayyeh BK. Prospective Multicenter Study of the Primary Obesity Surgery Endoluminal (POSE 2.0) Procedure for Treatment of Obesity. Clin Gastroenterol Hepatol. 2023 Jan;21(1):81-89.e4. doi: 10.1016/j.cgh.2022.04.019. Epub 2022 May 6.

    PubMed 35533995

Questions about this trial

What is this clinical trial studying?

A study testing Fundic Ablation in Combination with Endoscopic Sleeve Gastroplasty, Fundic Mucosal Ablation with ERBE HybridAPC and Apollo ESG in people with Obesity, run by True You Weight Loss 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 8 inclusion and 15 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 7 Dec 2023. 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?

Results are not available in the source record.

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?

Rate of Safety Complications (time frame: Week 1, Month 1, Month 2, Month 3, Month 4, Month 6, Month 7, Month 8, Month 9, Month 10, Month 11, Month 12). The study lists 2 primary outcomes in all. 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 NCT05992103, which also lists 10 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 7 Dec 2023.

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