<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03837691</url>
  </required_header>
  <id_info>
    <org_study_id>50527 TPR</org_study_id>
    <nct_id>NCT03837691</nct_id>
  </id_info>
  <brief_title>A Feasibility Study for the Treatment of Primary Obesity</brief_title>
  <official_title>A Feasibility Study Examining Safety and Preliminary Effectiveness of a Procedural Technique Using an Endoscopic Suturing Device and Associated Devices for the Treatment of Primary Obesity</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>USGI Medical</agency>
      <agency_class>Industry</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>USGI Medical</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>Yes</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      This study has been expanded to a four center, open-label, 2-group randomized pilot study&#xD;
      evaluating a treatment for obesity.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      This study has been expanded to a four center, open-label, 2-group randomized pilot study&#xD;
      evaluating a treatment for obesity. The intent is to evaluate the safety and preliminary&#xD;
      efficacy of a new Snowshoe suture placement pattern, Pose 2 (sutures placed in the mid +&#xD;
      distal body without fundus), with a moderate intensity diet and exercise program, as compared&#xD;
      to diet and exercise alone. The procedure will be performed using the g-Cath EZ Delivery&#xD;
      Catheter with Snowshoe Suture Anchors (AKA g-Cath or g-Cath EZ) and associated devices&#xD;
      (g-Prox EZ, g-Lix and Transport), known collectively as the Incisionless Operating Platform&#xD;
      (IOP). Efficacy will be evaluated based on changes in weight loss for all subjects through 12&#xD;
      months. Adverse events will be recorded throughout the duration of the study.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Active, not recruiting</overall_status>
  <start_date type="Actual">October 10, 2019</start_date>
  <completion_date type="Anticipated">October 15, 2023</completion_date>
  <primary_completion_date type="Anticipated">June 15, 2023</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Single Group Assignment</intervention_model>
    <intervention_model_description>Forty Patient Study</intervention_model_description>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Primary weight loss intervention</measure>
    <time_frame>12 months</time_frame>
    <description>To evaluate the safety and preliminary effectiveness of the Pose 2 procedure using the g-Cath EZ Suture Anchor Delivery Catheter as a primary weight loss intervention.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Changes in gastric emptying</measure>
    <time_frame>2 &amp; 6 months</time_frame>
    <description>To gather information on changes in gastric emptying breath test findings in order to correlate changes with weight loss outcomes.</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">40</enrollment>
  <condition>Obesity</condition>
  <arm_group>
    <arm_group_label>g-Cath EZ</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Placement of Snowshoe suture anchors from g-Cath EZ Delivery Catheters, in a defined pattern in the mid and distal portions of the stomach, along with a moderate intensity diet &amp; exercise program, to treat primary obesity.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Diet and Exercise</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>A moderate intensity diet &amp; exercise program to treat primary obesity</description>
  </arm_group>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Placement of Snowshoe Suture Anchors</intervention_name>
    <description>Snowshoe suture anchors from g-Cath EZ Delivery Catheters are placed in the stomach with the aid of a Transport, g-Lix and g-Prox device</description>
    <arm_group_label>g-Cath EZ</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Moderate Intensity Diet &amp; Exercise Program</intervention_name>
    <description>After placement of the snowshoe suture anchors in the stomach, subjects are asked to follow a moderate intensity diet and exercise program</description>
    <arm_group_label>g-Cath EZ</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          1. Provision of signed and dated informed consent form.&#xD;
&#xD;
          2. Subject agrees to be compliant with study requirements and adhere to post-operative&#xD;
             dietary &amp; exercise recommendations for the duration of the study.&#xD;
&#xD;
          3. Subjects between the ages of 22-60 years.&#xD;
&#xD;
          4. If female, be either post-menopausal, surgically sterile, or agree to practice birth&#xD;
             control during year of study and have negative serum HCG at screening/baseline.&#xD;
&#xD;
          5. Have a Body Mass Index (BMI) of ≥ 35 and &lt; 40 with one or more obesity related&#xD;
             co-morbid conditions (defined by 1991 NIH Guidelines (Appropriateness Criteria for&#xD;
             Bariatric Surgery: Beyond the NIH Guidelines)).&#xD;
&#xD;
               1. Pre-diabetes - Fasting plasma glucose test &gt;100 mg/dl but ≤125 or oral glucose&#xD;
                  tolerance test ≥140 mg/dl but &lt;200.&#xD;
&#xD;
               2. Diabetes - Individuals taking insulin and/or oral hypoglycemic medications or&#xD;
                  have a fasting glucose &gt;126 mg/dl.&#xD;
&#xD;
               3. Hypertension - SBP&gt;140 or DBP&gt;90 or the use of an antihypertensive medication.&#xD;
&#xD;
               4. Dyslipidemia - Triglycerides &gt; 250 mg/dl or cholesterol &gt; 220 mg/dl or HDL &lt; 35&#xD;
                  mg/dl or LDL &gt; 200 or use of lipid lowering medications.&#xD;
&#xD;
               5. Sleep Apnea - A formal sleep study test consistent with this diagnosis; Epworth&#xD;
                  sleepiness scale ≥ 6; Polysomnography with respiratory disturbance index ≥ 10&#xD;
                  hypopneic and/or apneic episodes per hour of sleep.&#xD;
&#xD;
               6. Venous Stasis Disease - Presence or history of pretibial venous stasis ulcers.&#xD;
&#xD;
               7. Chronic Joint Disease - Deterioration of joint cartilage and the formation of new&#xD;
                  bone (bone spurs) at the margins of the joints.&#xD;
&#xD;
          6. Absence of current severe systemic disease (including, but not limited to: coronary&#xD;
             artery disease, chronic obstructive pulmonary disease, congestive heart failure,&#xD;
             cancer, and chronic renal disease).&#xD;
&#xD;
          7. Agrees not to undergo any additional weight loss interventional procedures or&#xD;
             liposuction for 12 months following study enrollment.&#xD;
&#xD;
          8. Have not taken any prescription or over the counter weight loss medications or those&#xD;
             that can suppress appetite/induce weight loss for at least 6 months and agrees not to&#xD;
             utilize for 12 months following study enrollment (including all stimulant medication).&#xD;
&#xD;
          9. Subjects must be willing to possibly forego any future weight loss procedures (i.e.&#xD;
             Vertical Sleeve Gastrectomy) given the unknown long-term effects.&#xD;
&#xD;
         10. Residing within a reasonable distance from the Investigator's treating office (~50&#xD;
             miles) and willing and able to travel to the Investigator's office to complete all&#xD;
             routine follow-up visits.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          1. History of (or intra-operative evidence of) prior bariatric, gastric or esophageal&#xD;
             surgery.&#xD;
&#xD;
          2. Esophageal stricture or other anatomy and/or condition that could preclude passage of&#xD;
             endoluminal instruments or procedure execution.&#xD;
&#xD;
          3. Moderate gastro-esophageal reflux disease (GERD), defined as symptoms that cause&#xD;
             subject severe discomfort, compromise performance of daily activities, and/or&#xD;
             condition is not entirely controlled with drug therapy.&#xD;
&#xD;
          4. Large hiatal hernia (&gt;3 cm) by history or as determined by pre-enrollment endoscopy.&#xD;
&#xD;
          5. Pancreatic insufficiency/disease.&#xD;
&#xD;
          6. History of gastroparesis or symptoms that would be suggestive of gastroparesis or&#xD;
             generalized dysmotility (e.g. esophago-gastric motility issues and lower esophageal&#xD;
             sphincter abnormalities).&#xD;
&#xD;
          7. Pregnancy or plans of pregnancy in the next 12 months.&#xD;
&#xD;
          8. History of a known diagnosis or pre-existing symptom of rheumatoid arthritis,&#xD;
             scleroderma, system lupus, or other autoimmune connective tissue disorder.&#xD;
&#xD;
          9. Immunosuppressive medications or systemic steroids (i.e., oral prednisone) within 6&#xD;
             months of Visit 1. Intranasal/inhaled steroids are acceptable.&#xD;
&#xD;
         10. Unable or unwilling to avoid use of aspirin and/or non-steroidal anti-inflammatory&#xD;
             drugs (NSAIDs), or other medications known to be gastric irritants beginning two weeks&#xD;
             prior to enrollment and throughout the entire study.&#xD;
&#xD;
         11. History of inflammatory disease of the GI tract; coagulation disorders; hepatic&#xD;
             insufficiency or cirrhosis.&#xD;
&#xD;
         12. Active gastric erosion, lesion, or gastric/duodenal ulcer.&#xD;
&#xD;
         13. History of or current platelet or coagulation dysfunction, such as hemophilia.&#xD;
&#xD;
         14. History or present use of insulin or insulin derivatives for treatment of diabetes.&#xD;
&#xD;
         15. Type II Diabetes Mellitus (as defined by HgbA1c &gt;6.5%) for greater than 11 years at&#xD;
             the time of enrollment.&#xD;
&#xD;
         16. If smoker, plans to quit smoking in the year after enrollment.&#xD;
&#xD;
         17. Portal hypertension and/or varices.&#xD;
&#xD;
         18. Patient has a history of drug or alcohol abuse or positive at screening for drugs of&#xD;
             abuse.&#xD;
&#xD;
         19. Present or history of psychosis, bipolar disease, or obsessive-compulsive disorder&#xD;
             after pre-enrollment history and medical /psychological assessment.&#xD;
&#xD;
         20. Beck Depression Inventory (Short) Score ≥ 12 and/or uncontrolled depression after&#xD;
             pre-enrollment psychological and medical assessment.&#xD;
&#xD;
         21. Patient score &gt;2 in any of the 9 identified symptoms on the Gastroparesis Cardinal&#xD;
             Symptom Index (GCSI)&#xD;
&#xD;
         22. Patient with a 13C-Spirulina Gastric Emptying Breath Test (GEBT) result that is less&#xD;
             than a kPCD/min of 34.4 at 120 minutes or 43 at 180 minutes&#xD;
&#xD;
         23. Non-ambulatory or has significant impairment of mobility (i.e. cannot ambulate for 30&#xD;
             minutes).&#xD;
&#xD;
         24. Known hormonal or genetic cause for obesity including untreated hypothyroidism (TSH&#xD;
             &gt;5.0 U/ml).&#xD;
&#xD;
         25. Participating in another clinical study.&#xD;
&#xD;
         26. Subjects with a personal history of allergic/anaphylactic reactions including&#xD;
             hypersensitivity to the drugs or materials that will be utilized in the study&#xD;
             procedure.&#xD;
&#xD;
         27. Physician's assessment that the subject is not an appropriate candidate. If&#xD;
             significant findings for depression and/or suicidal ideation are identified, the&#xD;
             psychologist(s) assigned to the study will be contacted and arrangement will be made&#xD;
             for immediate intervention according to the Institution's standard procedure.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>22 Years</minimum_age>
    <maximum_age>60 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Barham Abu Dayyeh, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Mayo</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>University of Miami, Miller School of Medicine</name>
      <address>
        <city>Miami</city>
        <state>Florida</state>
        <zip>33166</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Brigham and Women's Hospital</name>
      <address>
        <city>Boston</city>
        <state>Massachusetts</state>
        <zip>02115</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Mayo Clinic</name>
      <address>
        <city>Rochester</city>
        <state>Minnesota</state>
        <zip>55905</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Memorial Hermann-Texas Medical Center</name>
      <address>
        <city>Houston</city>
        <state>Texas</state>
        <zip>77030</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <verification_date>May 2023</verification_date>
  <study_first_submitted>February 8, 2019</study_first_submitted>
  <study_first_submitted_qc>February 11, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">February 12, 2019</study_first_posted>
  <last_update_submitted>May 17, 2023</last_update_submitted>
  <last_update_submitted_qc>May 17, 2023</last_update_submitted_qc>
  <last_update_posted type="Actual">May 19, 2023</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Obesity</mesh_term>
  </condition_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03837691
org study id: 50527 TPR
nct id: NCT03837691
lead sponsor: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: Yes
This study has been expanded to a four center, open-label, 2-group randomized pilot study
      evaluating a treatment for obesity.
This study has been expanded to a four center, open-label, 2-group randomized pilot study
      evaluating a treatment for obesity. The intent is to evaluate the safety and preliminary
      efficacy of a new Snowshoe suture placement pattern, Pose 2 (sutures placed in the mid +
      distal body without fundus), with a moderate intensity diet and exercise program, as compared
      to diet and exercise alone. The procedure will be performed using the g-Cath EZ Delivery
      Catheter with Snowshoe Suture Anchors (AKA g-Cath or g-Cath EZ) and associated devices
      (g-Prox EZ, g-Lix and Transport), known collectively as the Incisionless Operating Platform
      (IOP). Efficacy will be evaluated based on changes in weight loss for all subjects through 12
      months. Adverse events will be recorded throughout the duration of the study.
allocation: Randomized
intervention model: Single Group Assignment
intervention model description: Forty Patient Study
primary purpose: Treatment
masking: None (Open Label)
measure: Primary weight loss intervention
time frame: 12 months
description: To evaluate the safety and preliminary effectiveness of the Pose 2 procedure using the g-Cath EZ Suture Anchor Delivery Catheter as a primary weight loss intervention.
measure: Changes in gastric emptying
time frame: 2 & 6 months
description: To gather information on changes in gastric emptying breath test findings in order to correlate changes with weight loss outcomes.
arm group label: g-Cath EZ
arm group type: Experimental
description: Placement of Snowshoe suture anchors from g-Cath EZ Delivery Catheters, in a defined pattern in the mid and distal portions of the stomach, along with a moderate intensity diet & exercise program, to treat primary obesity.
arm group label: Diet and Exercise
arm group type: No Intervention
description: A moderate intensity diet & exercise program to treat primary obesity
intervention type: Device
intervention name: Placement of Snowshoe Suture Anchors
description: Snowshoe suture anchors from g-Cath EZ Delivery Catheters are placed in the stomach with the aid of a Transport, g-Lix and g-Prox device
arm group label: g-Cath EZ
intervention type: Behavioral
intervention name: Moderate Intensity Diet & Exercise Program
description: After placement of the snowshoe suture anchors in the stomach, subjects are asked to follow a moderate intensity diet and exercise program
arm group label: g-Cath EZ
criteria: 
gender: All
minimum age: 22 Years
maximum age: 60 Years
healthy volunteers: No
last name: Barham Abu Dayyeh, MD
role: Principal Investigator
affiliation: Mayo
facility: 
facility: 
facility: 
facility: 
country: United States
responsible party type: Sponsor
mesh term: Obesity