Endoscopic full-thickness plication may reduce PPI usage and total reflux episodes in GERD patients, finds study

A recent meta-analysis published in the JGH Open Journal of Gastroenterology and Hepatology Foundation revealed that endoscopic full-thickness plication (EFTP) was effective in the treatment of gastroesophageal reflux disease (GERD), especially for patients unresponsive to conventional therapy.

GERD which is commonly managed with proton pump inhibitors (PPIs) is diagnosed in approximately 20% of adults in the United States. However, these medications are linked to potential long-term side effects, prompting the need for alternative solutions. The meta-analysis compared EFTP with a sham procedure as a treatment for refractory GERD. EFTP is a minimally invasive endoscopic technique designed to enhance the functionality of the gastroesophageal junction, addressing one of the root causes of GERD.

This research adhered to Cochrane guidelines and PRISMA standards in their systematic review. The study involved a total of 2144 screened articles, of which 3 high-quality randomized controlled trials (RCTs) with 272 patients met the inclusion criteria. Of these, 136 patients underwent EFTP, and the other 136 received sham procedures.

The analysis revealed strong evidence supporting the efficacy of EFTP. The patients who underwent EFTP demonstrated a significant reduction in dependency on PPIs when compared to the sham group. The relative risk (RR) was calculated at 0.51, with a 95% confidence interval (CI) of 0.35–0.73 (p < 0.01). This indicates a nearly 50% decrease in medication use.