'Treatment Outcome of Gastric Peroral Endoscopic Pyloromyotomy in Comparison With Percutaneous Endoscopic Gastrostomy With Jejunal Extension in Medically Refractory Gastroparesis: a Prospective Randomized Controlled Trial'
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Gastroparesis
- Sponsor
- Maastricht University Medical Center
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- Number of patients with treatment success using the GCSI-score in patients with refractory GP undergoing G-POEM compared to patients receiving a PEG-J at t = 6 months.
- Status
- Recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
Study design: A randomized non-blinded controlled clinical trial with two study arms (G-POEM and PEG-J). Treatment success is measured using the GCSI at baseline before intervention and six months after intervention with a possible cross-over after six months of follow-up.
Study population: 50 patients with therapy refractory GP on dietary advices, prokinetics and possibly tube feeding (gastric rest) who have already been referred for additional treatment options in the form of PEG-J/ G-POEM.
Intervention: Group 1 will receive G-POEM treatment and group 2 will receive PEG-J treatment.
Main study parameters/endpoints: A clinically meaningful treatment success six months after G-POEM treatment, measured using the GCSI-score defined as a decrease of 1 or more point.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients with GP
- •13C octanoic acid test or gastric scintigraphy (minimal 4-hour measurement) within the past twelve months
- •18 years old
Exclusion Criteria
- •\< 18 years old
- •Medical history of stomach surgery in which resection of antrum and/ or pylorus took place
- •Medical history of surgical or laparoscopic pyloromyotomy
- •Gastric bypass
- •Current opioid use
- •Pregnancy
Outcomes
Primary Outcomes
Number of patients with treatment success using the GCSI-score in patients with refractory GP undergoing G-POEM compared to patients receiving a PEG-J at t = 6 months.
Time Frame: 6 months
A treatment success will be defined as a decrease of at least one point on the GCSI (range 0-5), representing a clinically relevant difference, six months after intervention in comparison with baseline before intervention.
Secondary Outcomes
- Degree of quality of life using the PAGI-QOL in the G-POEM group in comparison with the PEG-J intervention six months after intervention.(6 months)
- Number and severity of (s)AEs in the treatment groups.(12 months)
- Predictive value of the etiology of gastroparesis on treatment outcomes following PEG-J by measuring the rate of treatment success quantified by improvements in the GCSI-score.(6-12 months)
- Number of patients with treatment success using the GCSI-score in patients with refractory GP undergoing G-POEM compared to patients receiving a PEG-J at t = 12 months.(12 months)
- Predictive value of the etiology of gastroparesis on treatment outcomes following G-POEM by measuring the rate of treatment success quantified by improvements in the GCSI-score.(6-12 months)