Authors: Ronnie Fass Frederick Cahn Dennis J Scotti David A Gregory
Publish Date: 2017/02/23
Volume: 31, Issue: 12, Pages: 4865-4882
Abstract
The endoscopic radiofrequency procedure Stretta has been used for more than a decade to treat patients with gastroesophageal reflux disease GERD However the efficacy of the procedure in improving objective and subjective clinical endpoints needs to be further establishedWe conducted a systematic search of the PubMed and Cochrane databases for English language clinical studies of the Stretta procedure published from inception until May 2016 Randomized controlled trials RCTs and cohort studies that included the use of the Stretta procedure in GERD patients were included A generalized inverse weighting was used for all outcomes Results were calculated by both fixed effects and random effects modelTwentyeight studies 4 RCTs 23 cohort studies and 1 registry representing 2468 unique Stretta patients were included in the metaanalysis The unweighted mean followup time for the 28 studies was 254 140 367 months The pooled results showed that the Stretta reduced improved the healthrelated quality of life score by −146 −1648 −1273 P 0001 Stretta also reduced improved the pooled heartburn standardized score by −153 −197 −109 P 0001 After Stretta treatment only 49 of the patients using proton pump inhibitors PPIs at baseline required PPIs at followup P 0001 The Stretta treatment reduced the incidence of erosive esophagitis by 24 P 0001 and reduced esophageal acid exposure by a mean of −301 −372 −230 P 0001 Lower esophageal sphincter LES basal pressure was increased post Stretta therapy by a mean of 173 −029 374 mmHg P = NSDennis J Scotti is a Parttime Consultant with Baker Tilly Virchow Krause LLC Baker Tilly Virchow Krause LLC is a Business Advisor to Mederi Therapeutics Inc David A Gregory is a principal with Baker Tilly a Business Advisor to Mederi Therapeutics Frederick Cahn is a principal with BioMedical Strategies a Business Advisor to Baker Tilly Ronnie Fass is an Advisor to Ironwood and Mederi Therapeutics Speaker for AstraZeneca Dr Reddy Mederi Therapeutics and Takeda and receives Research Grant from Ironwood
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