Aims To evaluate the efficacy and safety of anti reflux mucosal ablation (ARMA) in comparison
to proton pump inhibitors (PPIs) in patients with persistent GERD symptoms.
Methods In this non-randomized controlled interventional trial, between October 2023 to February
2024, patients with persistent GERD symptoms were allocated to either ARMA or PPI.
GERD-Health Related Quality of Life (GERD-HRQL) Questionnaire, Frequency Scale for
the Symptoms of GERD (FSSG), upper endoscopy, PPI use and adverse events were evaluated
at baseline and three months post-ARMA.
Results A total of 48 patients (31 females [64.6%]; mean age 39.47±14.88) completed our study
of 24 patients underwent ARMA (17 females [70.8%]; mean age 41.35±14.43) and 24 were
taking esomeprazole 20 mg twice daily. After three months, ARMA significantly alleviated
both mean GERD-HRQL (29.08±7.95 versus 7.42±3.85, P<0.001) and FSSG (24.71±5.17 versus
7.46±3.63, p<0.001). Furthermore, three-month GERD-HRQL and FSSG were significantly
lower in the ARMA group in comparison to the PPI group. (7.42±3.85 versus 23.83±7.29,
p<0.001 and 7.46±3.63 versus 20.75±5.33, p<0.001, respectively. Notably, 79.2% of
patients in the ARMA were able to discontinue PPIs in comparison to 8.3% of patients
in the control group (p<0.001). Multivariate analysis revealed that undergoing ARMA
was the only predictor of GERD-HRQL and FSSG scores. Only one patient experienced
heartburn after ARMA but no major adverse complications were observed [1]
[2]
[3]
[4].
Conclusions Our study demonstrated that ARMA was feasible, tolerable and safe. Also, in short-term,
it can alleviate the symptoms of GERD in patients with persistent symptoms more efficiently
in comparison to esomeprazole. However, longer follow-ups and randomized studies are
required to determine the exact efficacy of ARMA.
