Improvement of gastroesophageal reflux symptoms after radiofrequency energy: a randomized, sham-controlled trial.
OBJECTIVE
Gastroesophageal reflux disease is a prevalent disorder that often requires long-term medical therapy or surgery. The United States Food and Drug Administration recently cleared new endoluminal gastroesophageal reflux disease treatments; however, no controlled trials exist.


METHODS
We randomly assigned 64 gastroesophageal reflux disease patients to radiofrequency energy delivery to the gastroesophageal junction (35 patients) or to a sham procedure (29 patients). Principal outcomes were reflux symptoms and quality of life. Secondary outcomes were medication use and esophageal acid exposure. After 6 months, interested sham patients crossed over to active treatment.


RESULTS
At 6 months, active treatment significantly and substantially improved patients' heartburn symptoms and quality of life. More active vs. sham patients were without daily heartburn symptoms (n = 19 [61%] vs. n = 7 [33%]; P = 0.05), and more had a >50% improvement in their gastroesophageal reflux disease quality of life score (n = 19 [61%] vs. n = 6 [30%]; P = 0.03). Symptom improvements persisted at 12 months after treatment. At 6 months, there were no differences in daily medication use after a medication withdrawal protocol (n = 17 [55%] vs. n = 14 [61%]; P = 0.67) or in esophageal acid exposure times. There were no perforations or deaths.


CONCLUSIONS
Radiofrequency energy delivery significantly improved gastroesophageal reflux disease symptoms and quality of life compared with a sham procedure, but it did not decrease esophageal acid exposure or medication use at 6 months. This procedure represents a new option for selected symptomatic gastroesophageal reflux disease patients who are intolerant of, or desire an alternative to, traditional medical therapies.
Corley
Douglas A
DA
Division of Research, Kaiser Permanente, Oakland, California, USA. Douglas.Corley@kp.org
Katz
Philip
P
Wo
John M
JM
Stefan
Andreas
A
Patti
Marco
M
Rothstein
Richard
R
Edmundowicz
Steven
S
Kline
Michael
M
Mason
Rodney
R
Wolfe
M Michael
MM
D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D005764:Gastroesophageal Reflux / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011846:Radio Waves / Q000009:adverse effects; D000078702:Radiofrequency Therapy