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Endoscopic anterior fundoplasty for GERD reduces PPI use, reflux

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WASHINGTON — Results from an ongoing study on endoscopic anterior fundoplication for the treatment of GERD showed significant reduction in proton-pump inhibitor use and reflux periods, according to research presented at Digestive Disease Week 2018.

“Endoscopic anterior fundoplasty using the Medigus platform was successful in decreasing a patient’s need for PPI use and bothersome symptoms,” Ali Lankarani, MD, from the Boarland-Groover Clinic in Florida, told Healio Gastroenterology and Liver Disease. “This was objectively correlated with a decrease in the amount of reflux and was compatible with initial studies.”

The multicenter international study comprised 71 patients with GERD who underwent endoscopic anterior fundoplication (EAF) with the Medigus ultrasound surgical endostapler (MUSE) platform.

Lankarani and colleagues had previously reported 6-month and 12-month results. At DDW, Lankarani shared progressive data from patients who continued treatment through 1 year (n = 47) and 2 years (n = 15).

Health Related Quality of Life Questionnaire (GERD-HRQL) scores improved from 24 at baseline to 10 at 1 year and remained at 10 by year 2. Patient-reported satisfaction was approximately 74% at 1 year and 64% at 2 years.

A significant portion of patients were able to completely stop PPI use or reduce PPI use by at least 50% at 1 year (70%; P < .00001) and at 2 years (69%; P < .0009). Of those who responded to treatment, 87% were able to stop daily PPI use.

In a subset of 25 patients who had both baseline and 6-month pH results, 16% achieved normalized pH and 68% had a reduction in the percent of time spent in reflux. Among the patients with reduced time spent in reflux, 41% had a reduction of acid exposure ranging from 50% to 90%.

“We continue to monitor these patients for year 3 to show sustainability of this procedure in treatment of GERD,” Lankarani said. – by Talitha Bennett

Reference:

Lankarani A, et al. Abstract Su1122. Presented at: Digestive Disease Week; June 2-5, 2018; Washington, D.C.

Disclosure: Lankarani reports no relevant financial disclosures.