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Endoscopic sleeve gastroplasty effective, ‘can be safely introduced’
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Endoscopic sleeve gastroplasty produced clinically significant weight loss in patients with obesity, according to results of a meta-analysis.
Vivek Kumbhari, MD, director of bariatric endoscopy at Johns Hopkins Medical Institutions, and colleagues wrote that endoscopic sleeve gastroplasty (ESG) is gaining traction in the world of obesity management despite having limited data comparing it to other weight loss methods, including bariatric surgery.
“This is dissimilar to other endoscopic bariatric therapies, including intragastric balloons and aspiration therapy, where level 1 evidence exists,” they wrote. “Therefore, there is a need to synthesize the available literature pertaining to ESG to arm the clinician with the data required to facilitate a data driven discussion with patients interested in the procedure.”
Investigators searched the literature for studies that explored total body weight loss (TBWL), BMI reduction, percent excess weight loss (EWL) and adverse events. They identified eight studies comprising 1,772 patients that fit their criteria.
At 6 months of follow-up, the mean TBWL was 15.1% (95% CI, 14.3%–16%), mean decrease in BMI was 5.65 kg/m² (95% CI, 5.07–6.22) and mean EWL was 57.7% (95% CI, 52%–63.4%). Patients sustained weight loss at 12 months with a mean TBWL of 16.5% (95% CI, 15.2%–17.8%), as well as at 18 to 24 months with a mean TBWL of 17.2% (95% CI, 14.6%–19.7%).
In their safety assessment, researchers found that the pooled rate of adverse events after ESG was 2.2% (95% CI, 1.6%–3.1%). Commonly reported adverse events included, pain or nausea requiring hospitalization (n = 18; 1.08%), upper gastrointestinal bleeding (n = 9; 0.56%) and peri-gastric leak or fluid collection (n = 8; 0.48%).
Kumbhari and colleagues called for future research to further explore ESG, including health outcomes, cost-effectiveness and compared with bariatric surgery and other weight loss interventions.
“The evidence from this meta-analysis suggests that ESG can be safely introduced into clinical practice for treatment of obesity and obesity-associated disease,” they wrote. “The durability and weight loss results of ESG at 12 months suggest that this endoscopic technique is effective, resulting in clinically significant weight loss, sustained over at least the intermediate term.” – by Alex Young
Disclosures: Kumbhari reports consulting for Apollo Endosurgery, Boston Scientific, Medtronic and Reshape Lifesciences. He also reports receiving research support from Apollo Endosurgery and ERBE. Please see the full study for all other authors’ relevant financial disclosures.
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