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Stretta therapy

Meta-analysis shows Stretta significantly improves outcomes

Stretta is a transoral, non-surgical intervention that uses low power radiofrequency (RF) energy to remodel the muscle between the stomach and oesophagus

The Stretta procedure significantly improves subjective and objective clinical endpoints, except LES basal pressure, and therefore should be considered as a viable alternative in managing gastroesophageal reflux disease (GERD), these are the conclusions of a meta-analysis of 28 studies, representing 2,468 patients who received Stretta Therapy to treat GERD.

Stretta is a transoral, non-surgical intervention that uses low power radiofrequency (RF) energy to remodel the muscle between the stomach and oesophagus. Studies demonstrate that Stretta resolves reflux symptoms, improves quality of life, reduces or eliminates medications, and decreases acid exposure in patients with chronic GERD.

Stretta therapy delivers low power, low temperature radiofrequency energy to remodel the valve known as the lower oesophageal sphincter (LES) at the junction of the oesophagus and the stomach. Stretta reduces or eliminates regurgitation of stomach contents by improving muscle tone and reducing random openings of the LES that are known to cause GERD. Stretta treatment results in elimination or significant reductions of GERD symptoms and medication use, and significant improvement in a patient's quality of life. (Credit: PRNewsFoto/Mederi Therapeutics Inc.)

The study, ‘Systematic Review and Meta-Analysis of Controlled and Prospective Cohort Efficacy Studies of Endoscopic Radiofrequency for Treatment of Gastroesophageal Reflux Disease’, published in Surgical Endoscopy, was directed by Dr Ronnie Fass, head of the Esophageal and Swallowing Center, Director of Gastroenterology and Hepatology at Metro Health Medical Center and Professor at Case Western University, and statistical expert Dr Frederick Cahn, principal of Biomedical Strategies.

“This comprehensive analysis combined our clinical expertise with Dr Cahn’s statistical experience to produce the most thorough and objective review of currently available data,” said Fass. “The results of this study show that Stretta significantly reduces GERD symptoms while also impacting the physiological parameters, such as reducing acid exposure, and healing erosive esophagitis. The results demonstrate that Stretta is a clinically effective and safe therapy for GERD.”

The pooled results showed that the Stretta reduced (improved) the health-related quality of life score by −14.6 [−16.48, −12.73] (p<0.001). Stretta also reduced (improved) the pooled heartburn standardized score by −1.53 [−1.97, −1.09] (p<0.001).

After Stretta treatment, only 49% of the patients using proton pump inhibitors (PPIs) at baseline required PPIs at follow-up (p<0.001). The Stretta treatment reduced the incidence of erosive esophagitis by 24% (p<0.001) and reduced oesophageal acid exposure by a mean of −3.01 [−3.72, −2.30] (p<0.001). Lower oesophageal sphincter (LES) basal pressure was increased post Stretta therapy by a mean of 1.73 [−0.29, 3.74] mmHg (p=NS).

“A thorough analysis of the studies, following Cochrane recommended methodology, demonstrated they are of a high quality with low risk of bias,” said Cahn. “We also noted a consistency of positive outcomes across the wide range of studies. Strengths of this meta-analysis include: up to 10-years of follow-up (average 25 months), a large number of subjects (2,468), and the inclusion of 28 studies, which places this meta-analysis in the top 1% of systematic reviews and meta-analyses.”

“This in-depth data analysis confirms that Stretta is safe and effective in treating GERD,” said Bob Knarr, CEO of Mederi. “This new study together with the economic data make Stretta a win for patients and payers alike, improving quality of care while reducing costs.”

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