Trial | NCT02055014  Report issue

Title

Randomisation to Endobarrier Alone Versus With Incretin Analogue in SustainEd Diabesity (REVISE-Diabesity)
Randomisation to Endoluminal Intestinal Liner Alone Versus With Incretin Analogue in SustainEd Diabesity (REVISE-Diabesity)

  • Phase

    Phase 4

  • Study Type

    Interventional

  • Status

    Unknown status

  • Intervention/Treatment

    liraglutide ...

  • Study Participants

    72
New effective non-surgical treatments are needed for patients whose obesity and type 2 diabetes (T2DM) do not respond to current medical therapies. We propose a randomised controlled trial of Endobarrier, an implantable intestinal device that separates ingested food from contacting the first 60cm of intestine where sited and that mimics some of the clinical effects of bariatric surgery (improved metabolic control with weight loss) with or without continued use of the GLP-1 receptor agonist (GLP-1RA) Liraglutide 1.2mg vs Liraglutide 1.8mg without the device in obese patients with T2DM who remain with suboptimal glycaemic control despite current conventional diabetes treatment, in an NHS setting.

Seventy-two patients with T2DM and obesity (HbA1c≥7.5%, BMI≥35kg/m2) despite previous GLP-1RA therapy will be studied over 24 months and randomised to receive Endobarrier with continued Liraglutide 1.2mg for 12 months; Endobarrier alone for 12 months; or Liraglutide 1.8mg without Endobarrier.

We will investigate potential mechanisms of action and their time course as part of the study by repeated measures of: 1. insulin resistance measures, gut peptides, bile acids; 2. energy intake and nutritional composition; 3. liver fat stores, 4. intestinal inflammation and permeability measures.

The data will inform clinical use of the device and development of new treatments for T2DM and obesity.
Study Started
Jul 31
2013
Primary Completion
Mar 31
2017
Anticipated
Study Completion
Mar 31
2017
Anticipated
Last Update
Apr 26
2016
Estimate

Drug Liraglutide

  • Other names: Victoza

Device Duodenal-jejunal bypass liner - Endobarrier device

  • Other names: EC Certificate Full Quality Assurance System: Certificate US08/5323

Liraglutide alone Active Comparator

Liraglutide 1.8mg once daily subcutaneous injection

Endobarrier alone Experimental

Duodenal-jejunal bypass liner (Endobarrier) device implantation without additional GLP-1RA therapy

Endobarrier and Liraglutide Experimental

Duodenal-jejunal bypass liner (Endobarrier) device with combined liraglutide 1.2mg once daily subcutaneous injection

Criteria 

Inclusion Criteria:

type 2 diabetes with latest HbA1c ≥7.5% (≥58mmol/mol)
obesity with latest BMI ≥35 Kg/m2 (≥30 Kg/m2 for those of South Asian origin)
liraglutide therapy for at least 6 months - HbA1c and weight trend data should be available
stable weight and HbA1c in preceding 3 months (<3 Kg reduction in weight and <0.3% reduction in HbA1c)

Exclusion Criteria:

<18 years of age
abnormal intestinal anatomy e.g. Crohn's disease
contraindication to oesophago-gastroduodenoscopy
previous bariatric surgery or bowel surgery
active infection
anticoagulation therapy which cannot be discontinued/ coagulopathy INR >1.3
eGFR <30
known portal hypertension
previous pancreatitis or amylase > 3 times the upper limit of normal
uncontrolled cardiovascular disease
lactating or pregnant females
patients taking aspirin in whom it should continue (e.g. active ischaemic heart disease or cerebrovascular disease)
excess anaesthetic risk as identified by the anaesthetist or investigator (e.g. uncontrolled obstructive sleep apnoea)
No Results Posted