A new study suggests magnetic sphincter augmentation (MSA) is associated with favorable clinical outcomes in gastroesophageal reflux disease (GERD), particularly in younger patients.

Researchers at Allegheny Health Network (Pittsburgh, PA, USA) conducted a retrospective review of prospectively collected data involving of 553 patients who underwent MSA with the Ethicon Endo-Surgery (Ethicon, Cincinnati, OH, USA) LINX device. Preoperative clinical, endoscopic, manometric, and pH data were analyzed to determine factors predicting a favorable outcome, which was defined as freedom from proton pump inhibitor (PPI) use and a higher than 50% improvement in GERD Health-Related Quality of Life (GERD-HRQL) total score.

The results showed that at 10 month follow-up, 92.7% of the patients were free of PPI use, and 84% reported at least 50% improvement in their GERD-HRQL total score, from a mean baseline value of 33.8 to 7.2; 76.1% of the patients had normalization of esophageal acid exposure. Independent predictors of a favorable outcome after MSA included age younger than 45 years, male sex, GERD-HRQL total score higher than 15, and abnormal DeMeester score. The study was published in the May 2020 issue of the Journal of the American College of Surgery (JACS).

“Patients reported significant improvement in GERD health-related quality of life after MSA implantation and about 90% of them discontinued daily use of anti-acid medications,” said lead author Shahin Ayazi, MD. “The finding of younger age as a predictor of successful outcome highlights the importance of early surgical intervention in the management of reflux disease.”

The LINX MSA is made of a series of titanium beads with a magnetic core, connected together with independent titanium wires so as to form a ring that is wrapped around the lower esophageal sphincter (LES). The magnetic forces between the beads help keep the weakened LES closed, preventing reversed flow of stomach contents. When eating, the magnetic forces are overcome by the higher pressures of swallowing forces, and the device expands to accommodate food or liquid. Once food passes though the LES, the device returns to its resting state.

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