Magnetic sphincter augmentation linked with long-term safety, efficacy for GERD
Magnetic sphincter augmentation resulted in long-term safety in efficacy regarding symptom improvement, decreased drug dependency and reduced esophageal acid exposure in gastroesophageal reflux disease.
“MSA may represent a true paradigm shift that has the potential to fill the current therapy gap in GERD,” Davide Ferrari, MD, from the department of biomedical sciences for health at the University of Milan and colleagues wrote in Scientific Reports. “A randomized clinical trial comparing MSA and either total or partial fundoplication could provide more robust and definitive conclusions.”
Ferrari and colleagues reviewed a prospectively maintained database to evaluate the long-term safety and efficacy of a laparoscopic sphincter augmentation in 335 patients. Investigators followed 124 patients from 6 to 12 years following surgery. Investigators compared long-term outcomes from baseline regarding gastroesophageal reflux disease health related quality of life (GERD-HRQL), use of protonpump inhibitors (PPI) and esophageal acid exposure.
“Favorable outcomes were defined as [50% or greater] improvement of -total score and PPI discontinuation,” Ferrari and colleagues wrote.
Results showed improvements in mean total GERD-HRQL from 19.9 to 4.01 (P < .001). Investigators reported PPIs were discontinued in 79% of patients. Age younger than 40 years at intervention (OR = 4.17) and GERD-HRQL score over 15 (OR = 4.09) were independent predictors of a favorable outcome.
“The mean total percent time with pH [less than 4] decreased from 9.6% at baseline to 4.1% (P < .001), with 89% of patients achieving pH normalization,” the researchers wrote.