Antireflux mucosal ablation safe, effective for refractory reflux disease

Antireflux mucosal ablation (ARMA) cuts short-term gastroesophageal reflux disease (GERD) symptoms in two-thirds of patients undergoing the endoscopic treatment, according to a study published in the Journal of Gastroenterology and Hepatology.

Yuto Shimamura, M.D., from Showa University in Tokyo, and colleagues evaluated the feasibility, safety, and effectiveness of ARMA. The analysis included 68 patients with GERD symptoms refractory to acid suppression medications or those dependent on such medications.

The researchers found that clinical success rates (defined as >50 percent reduction in a validated GERD questionnaire) at two to six months and one year post-ARMA were 60 and 70 percent, respectively. There were significant improvements seen in the median GERD health-related quality of life score from 26 to 11 at two to six months.

Among those who underwent 24-hour pH monitoring (51 patients), median acid exposure time significantly decreased from 5.3 to 0.7 percent, along with a significant reduction in esophagitis rates. No factors predicted short-term success in a multivariate analysis. Transient stenosis requiring balloon dilation was seen in nine patients (13.2 percent).

"Both reflux hypersensitivity and confirmed GERD patients, regardless of their response to acid suppression medication, may be suitable candidates," the authors write.

Several authors disclosed ties to industry.