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Trial registered on ANZCTR
Registration number
ACTRN12619000066189p
Ethics application status
Not yet submitted
Date submitted
17/12/2018
Date registered
17/01/2019
Date last updated
17/01/2019
Date data sharing statement initially provided
17/01/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Endoscopic Sleeve Gastroplasty for fatty liver disease and metabolic syndrome
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Scientific title
Investigating the effect of Endoscopic Sleeve Gastroplasty (ESG) on Non-alcoholic Fatty Liver Disease (NAFLD) and the metabolic syndrome in obese participants
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Secondary ID [1]
296893
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nil
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Universal Trial Number (UTN)
U1111-1225-6797
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Non Alcoholic fatty Liver Disease
310839
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Obesity
310840
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Metabolic syndrome
310841
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Condition category
Condition code
Oral and Gastrointestinal
309512
309512
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Diet and Nutrition
309513
309513
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0
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Obesity
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Metabolic and Endocrine
309514
309514
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients with Non-alcoholic fatty liver disease, who are obese (BMI 30- 45Kg/m2) will be assessed for the intervention. This will include a liver biopsy to assess the degree of fatty liver disease.
If included in the trial, the intervention is an Endoscopic Sleeve gastroplasty (ESG) which will be undertaken under general anesthetic in patients with non-alcoholic fatty liver disease and metabolic risk factors.
The procedure will be performed at Auckland City Hospital, the interventional endoscopist is Dr David Orr, who has been undertaking interventional endoscopy at Auckland Hospital for >12 years and at King's College Hospital, London before this time.
Patients will be assessed and followed up by a specialist team of bariatric nurse, dietician and psychologist.
The procedure duration is 1.5 hours. A gastroscope is passed into the stomach to confirm that there are no contra-indications to proceeding with the ESG. The stomach is then marked to show the orientation of the stomach for the endoscopist during the procedure. The Overstitch device is then attached to the endoscope and placed into the stomach. Approximately 8 stitches are placed in a double layer pattern to reduce the diameter and shorten the stomach. You will remain in hospital for one night post procedure. After discharge, you will be seen in outpatient clinic at week 1, then monthly for 3 months, then every 3 months for up to 2 years at Auckland Hospital.
1 year after the procedure, you will undergo a repeat liver biopsy to assess if the ESG has resulted in improvement and/or resolution of your non-alcoholic fatty liver disease.
As part of standard of care, you will continue follow up in the hepatology clinic every 3 months after the procedure.
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Intervention code [1]
313169
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Treatment: Surgery
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Comparator / control treatment
No Control Group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Liver biopsy assessment of change in Non Alcoholic Fatty Liver Disease histologic score (NAFLD Activity Score; NAS).
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Assessment method [1]
308468
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Timepoint [1]
308468
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1 year post ESG Liver Biopsy
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Secondary outcome [1]
355041
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Change in insulin resistance with blood test, 1 year post ESG
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Assessment method [1]
355041
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Timepoint [1]
355041
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1 year post ESG
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Secondary outcome [2]
355042
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Weight loss (total body weight change measured on electronic scales in Kg) at 1 year post ESG
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Assessment method [2]
355042
0
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Timepoint [2]
355042
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1 year post ESG
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Secondary outcome [3]
355043
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Change in blood pressure with bench top spygmomanometer 1 year post ESG
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Assessment method [3]
355043
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Timepoint [3]
355043
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1 year post ESG
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Secondary outcome [4]
355044
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Change in liver fat on fibroscan at 1 year post ESG
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Assessment method [4]
355044
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Timepoint [4]
355044
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1 year post ESG, fibroscan assessment of liver fat with computerised attenuation parameter (CAP)
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Secondary outcome [5]
355045
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Change in lipid profile at 1 year post ESG with blood test.
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Assessment method [5]
355045
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Timepoint [5]
355045
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1 year post ESG blood test
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Eligibility
Key inclusion criteria
1. Liver biopsy with NAFLD/NASH (NAS score greater than or equal to 4), (or historic biopsy within 6-months)
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2. BMI 30- 45Kg/m2. AND at least one additional metabolic risk factor: (HT, Type II diabetes or dyslipidaemia).
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3. Age 20- 65
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Minimum age
20
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients with cirrhosis of the liver and/or portal hypertension,
Antiplatelet therapy (excluding low dose aspirin),
Severe cardiac or respiratory disease, Previous gastric surgery, Hiatus hernia >3cm
Inflammatory bowel disease,
Pregnancy, or breast feeding.
No other liver disease (excluded viral hepatitis, AIH, HFe, alpha-1 AT deficiency),
Medications known to cause steatohepatitis.
Alcohol consumption: >21U/ week male, >14U/week female
Unable to follow dietary guidelines.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
not applicable
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Pilot trial to look at efficacy in 10 patients
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
20/05/2019
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Actual
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Date of last participant enrolment
Anticipated
18/11/2019
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Actual
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Date of last data collection
Anticipated
22/11/2021
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Actual
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Sample size
Target
10
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
21131
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New Zealand
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State/province [1]
21131
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Auckland
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Funding & Sponsors
Funding source category [1]
301464
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Hospital
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Name [1]
301464
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Auckland City Hospital Trust
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Address [1]
301464
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Auckland City Hospital
Park Road, Grafton
Auckland
1148
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Country [1]
301464
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New Zealand
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Primary sponsor type
Hospital
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Name
New Zealand Liver Transplant Unit
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Address
Auckland City Hospital
Level 15
Park Road, Grafton
Auckland
1148
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Country
New Zealand
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Secondary sponsor category [1]
301155
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None
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Name [1]
301155
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Address [1]
301155
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Country [1]
301155
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
302199
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Health and Disability Ethics Committe
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Ethics committee address [1]
302199
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Ministry of Health
Health and Disability Ethics Committees
PO Box 5013
Wellington 6140
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Ethics committee country [1]
302199
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New Zealand
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Date submitted for ethics approval [1]
302199
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11/02/2019
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Approval date [1]
302199
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Ethics approval number [1]
302199
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Summary
Brief summary
The aim of the study is to initiate weight loss with endoscopic sleeve gastroplasty (ESG). The study hopes to show that ESG results in significant weight loss and improves fatty liver disease, diabetes, blood pressure and cholesterol.
Endoscopic Sleeve Gastroplasty is an incisionless procedure that uses an endoscope which can suture the stomach. The stomach volume is reduced by 50-70% under general anaesthetic. This is accomplished by a series of endoscopically placed sutures extending from the bottom 1/3 of the stomach to the upper stomach creating a “sleeve”. Patients aged 20 to 65 years who are overweight (BMI 30-45Kg/m2), have fatty liver disease on liver biopsy and elevated insulin-glucose ratio, or diabetes, or hypertension or elevated cholesterol will be eligible for the trial.
You will be followed up over the next 2 years, with a repeat liver biopsy 1 year after the procedure to assess if the fatty liver disease has resolved or improved.
Your insulin resistance or diabetes, blood pressure and cholesterol will also be assessed to determine if the intervention improves these metabolic risk factors.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr David Orr
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Address
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New Zealand Liver Transplant Unit
Auckland City Hospital,
Park Road
Grafton
Auckland 1148
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Country
89450
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New Zealand
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Phone
89450
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+6493074949
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Fax
89450
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Email
89450
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[email protected]
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Contact person for public queries
Name
89451
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Dr David Orr
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Address
89451
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New Zealand Liver Transplant Unit
Auckland City Hospital,
Park Road
Grafton
Auckland 1148
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Country
89451
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New Zealand
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Phone
89451
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+6493074949
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Fax
89451
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Email
89451
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[email protected]
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Contact person for scientific queries
Name
89452
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Dr David Orr
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Address
89452
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New Zealand Liver Transplant Unit
Auckland City Hospital,
Park Road
Grafton
Auckland 1148
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Country
89452
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New Zealand
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Phone
89452
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+6493074949
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Fax
89452
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Email
89452
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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