Endoscopy 2021; 53(S 01): S87
DOI: 10.1055/s-0041-1724474
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Anti-Reflux Mucosal Ablation (ARMA) For Refractory Gastroesophageal Reflux Disease – An Interim Analysis

R Kalapala
1   Asian Institute of Gastroenterology, Medical Gastroenterology, Hyderabad, India
,
N Jagtap
1   Asian Institute of Gastroenterology, Medical Gastroenterology, Hyderabad, India
,
Z Nabi
1   Asian Institute of Gastroenterology, Medical Gastroenterology, Hyderabad, India
,
S Darisetty
2   Asian Institute of Gastroenterology, Anaesthesia, Hyderabad, India
,
H Kanakagiri
2   Asian Institute of Gastroenterology, Anaesthesia, Hyderabad, India
,
R Goud
1   Asian Institute of Gastroenterology, Medical Gastroenterology, Hyderabad, India
,
A Karaympudi
1   Asian Institute of Gastroenterology, Medical Gastroenterology, Hyderabad, India
,
DN Reddy
1   Asian Institute of Gastroenterology, Medical Gastroenterology, Hyderabad, India
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    Aims Proton pump inhibitor (PPI) refractory gastroesophageal reflux disease (GERD) is major clinical problem. Minimally invasive endoscopic therapies are being developed such as anti-reflux mucosal ablation. We describe safety and short term efficacy of ARMA in PPI-refractory GERD.

    Methods In this single center, prospective single arm ongoing interventional trial evaluating the outcome of ARMA in 29 patients with PPI refractory GERD. GERD – Health Related Quality of Life Questionnaire (GERD-HRQL) evaluation was analyzed at baseline, 3 and 6 months in 20 patients and compared using ANOVA of repeated measures. Impedance-pH monitoring was performed in all patients at baseline and at 3 months in 10 patients and compared using paired t test. The p value of < 0.05 was considered as statistically significant.

    Results A total of 29 patients (Mean age (SD) 39.59 (12.33) years; 10 female) underwent ARMA between September 2019 to September 2020. Mean procedure time was 29 (range 24 – 30) minutes. There were no major adverse event and all patients were discharged within 48 hours. Mean GERD-HRQL was improved from 39.90 (8.39) at baseline to 9.15 (6.66) at 3 months and 4.85 (5.17) at 6 months (p 0.001). There was significant improvement in heart burn and regurgitation score at 3 and 6 months (p 0.0001). There is trend towards improvement in DeMeester Score (41.52 (52.01) to 25.66 (43.08); p 0.415) and acid exposure time (24.48 (9.45) to 8.23 (14.68); p 0.048) from baseline to 3 months.

    Tab. 1

    Parameter

    Baseline

    3month

    6 month

    P value

    GERD HRQL (n = 20)

    39.90 (8.39)

    9.15 (6.66)

    4.85 (5.17)

    0.001

    Heart burn score (n = 20)

    19.05 (11.51)

    5.35 (5.78)

    2.70 (2.85)

    0.0001

    Regurgitation score (n = 20)

    20.45 (8.40)

    3.45 (5.30)

    2.15 (3.76)

    0.0001

    Acid Exposure time (n = 10)

    24.48 (9.45)

    8.23 (14.68)

    0.048

    Conclusions Our initial results shown that ARMA is safe endoscopic therapeutic option for PPI-refractory GERD with significant improvement in symptoms. Objective acid reflux parameters will be studied at 12 months.

    Citation: Kalapala R, Jagtap N, Nabi Z et al. OP210 ANTI-REFLUX MUCOSAL ABLATION (ARMA) FOR REFRACTORY GASTROESOPHAGEAL REFLUX DISEASE – AN INTERIM ANALYSIS. Endoscopy 2021; 53: S87.


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    Publication History

    Article published online:
    19 March 2021

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