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DOI: 10.1055/s-0041-1724474
Anti-Reflux Mucosal Ablation (ARMA) For Refractory Gastroesophageal Reflux Disease – An Interim Analysis
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.
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.
Publication History
Article published online:
19 March 2021
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