Intra-gastric Fundal and Body Injection of Botulinum Toxin A for Weight Loss, a Randomized Controlled Trial
Overview
- Phase
- Phase 2
- Intervention
- Botulinum toxin type A
- Conditions
- Obesity
- Sponsor
- Tan Tock Seng Hospital
- Enrollment
- 18
- Locations
- 1
- Primary Endpoint
- Weight loss
- Last Updated
- 6 years ago
Overview
Brief Summary
This is a randomized controlled trial to compare intra-gastric injection of Botulinum Toxin A (Botox; Allergan Inc. Irvine, Ca, USA) against non-surgical management for obesity (i.e. exercise/diet). Our hypothesis is that intra-gastric injection of Botox into the fundus and body of the stomach will result in greater weight loss than just exercise and diet alone.
Investigators
Danson Yeo Xue Wei
Associate Consultant
Tan Tock Seng Hospital
Eligibility Criteria
Inclusion Criteria
- •Age 21 to 65yrs old
- •BMI \>32.5 (Class II obesity)
Exclusion Criteria
- •Pregnancy or lactation
- •Known pre-existing neuromuscular disorders or peripheral motor neuropathic disease (e.g. amyotrophic lateral sclerosis, motor neuropathy)
- •Patients with known liver cirrhosis or known esophageal/gastric varices
- •Known eating disorders
- •Known major cardiovascular or pulmonary conditions
- •Previous gastric/bariatric surgery
- •Pathologic changes of the esophagus/stomach/duodenum demonstrated on endoscopy (esophagitis, peptic ulcers, cancer)
- •Known alcohol or drug abuse
- •Known allergy to any ingredients in Botox or allergic reaction to any other botulinum toxin product
Arms & Interventions
Intervention Arm
Patients in the intervention arm will receive 300units of Botulinum Toxin A (Botox; Allergan Inc., Irvine, Ca, USA) diluted to 10mls of saline. Endoscopy will be performed using a single-lumen gastroscope. Injection of the solution will be done using a 23Gauge Interject needle catheter. 20 separate injections of 0.5ml each will be performed in a concentric ring 1cm apart. 10 injections will be performed into the body of the stomach, and 10 injections into the fundus, from the level of the CEJ and above Patients will undergo a 12-week weight management program approximately 2 weeks after the injection of Botox.
Intervention: Botulinum toxin type A
Intervention Arm
Patients in the intervention arm will receive 300units of Botulinum Toxin A (Botox; Allergan Inc., Irvine, Ca, USA) diluted to 10mls of saline. Endoscopy will be performed using a single-lumen gastroscope. Injection of the solution will be done using a 23Gauge Interject needle catheter. 20 separate injections of 0.5ml each will be performed in a concentric ring 1cm apart. 10 injections will be performed into the body of the stomach, and 10 injections into the fundus, from the level of the CEJ and above Patients will undergo a 12-week weight management program approximately 2 weeks after the injection of Botox.
Intervention: Weight Management Program
Control Arm
Patients will undergo a 12-week weight management program.
Intervention: Weight Management Program
Outcomes
Primary Outcomes
Weight loss
Time Frame: 1 year
Examine the average weight loss
Time to weight regain following a single injection of intra-gastric Botox
Time Frame: 1 year
Secondary Outcomes
- Gut hormone level(1 year)
- Gut hormone level ( Leptin)(1 year)
- Satiety index(1 year)
- Co-morbidities(1 year)