- Magnetic sphincter augmentation (MSA) is superior to proton pump inhibitor (PPI) therapy for reducing regurgitation in patients with gastroesophageal reflux disease (GERD).
Why this matters
- PPIs are often ineffective for treating regurgitation, despite a common belief that medications are sufficient therapy.
- Researchers in this prospective, multicentre 2:1 trial studied patients with moderate to severe regurgitation despite once-daily PPI therapy, randomly assigning them to treatment with either a twice-daily PPI (omeprazole 20 mg; n=102) or laparoscopic MSA (n=50).
- Patients in the PPI treatment group who showed no improvement were offered MSA at 6 months.
- Funding: Ethicon, Inc.
- All patients who received MSA and and those who crossed over to the MSA group after PPI therapy (n=75) had similar outcomes and experienced no serious adverse events.
- MSA controlled regurgitation in 96% (n=72) of patients, independent of preoperative PPI response.
- Only 19% (8/43) of patients who received PPIs without MSA reported regurgitation control.
- 81% of MSA-treated patients had ≥50% improvement in GERD health-related QoL scores, and 91% discontinued daily PPI use.
- Other benefits included reduced dysphagia (from 15% to 7%), bloating (55% to 25%), and esophageal acid exposure time (10.7% to 1.3%) at 1 year.
- Follow-up was limited to 1 year.