Effect of the EndoBarrier Device: a 4-Year Follow-up of a Multicenter Randomized Clinical Trial

Rijn, Selwyn van; Roebroek, Yvonne G. M.; Jonge, Charlotte de; Greve, Jan; Bouvy, Nicole D.

doi:10.1007/s11695-018-03659-6

Cited by 22 publications

(16 citation statements)

References 23 publications

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“…At 9 or 12 months after balloon insertion (3 or 6 months from balloon removal), the %weight loss and % EWL tended to decrease. In the long-term follow-up in a previous RCT of DJBL, the effect of weight reduction on the initial DJBL treatment diminished after 4 years of follow-up [9]. Given these findings, selecting a relatively long-term treatment option among the bariatric endoscopic procedures may help to maximize weight loss.…”

Section: Methodsmentioning

confidence: 98%

“…These include an intragastric balloon that occupies space in the stomach (either with the device or by causing delayed gastric emptying) [6], a device that removes a portion of the calories consumed after a meal (aspiration therapy) [7], and an endoscopic technique that alters gastric anatomy to reduce gastric volume and accommodation (e. g. POSE) [8]. We can also use an endoscopically delivered DJBL that prevents the interaction of food with digestive substances throughout the foregut [9]. These endoscopic procedures are more effective than lifestyle modification or pharmacologic therapy in weight loss [5,10].…”

Section: Introductionmentioning

confidence: 99%

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Comparative efficacy of bariatric endoscopic procedures in the treatment of morbid obesity: a systematic review and network meta-analysis

et al. 2020

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Background The comparative efficacy of bariatric endoscopic procedures has not been completely elucidated. We aimed to comprehensively evaluate the efficacy of bariatric endoscopic procedures. Methods We searched for randomized controlled trials investigating the efficacy of bariatric endoscopic procedures, including the use of an intragastric balloon, duodenal-jejunal bypass liner (DJBL), aspiration therapy, primary obesity surgery endoluminal (POSE) procedure, and botulinum toxin injection to the stomach. Network meta-analyses were performed to determine the percentage of weight loss (%weight loss) and percentage of excess weight loss (%EWL). Results 22 studies with 2141 patients were included in the meta-analysis. Most endoscopic procedures showed superior efficacy in terms of %weight loss compared with the control (mean difference [MD] [95 % confidence interval (CI)]: aspiration therapy 10.4 % [7.0 % to 13.7 %]; fluid-filled balloon 5.3 % [3.4 % to 7.2 %]; POSE 4.9 % [1.7 % to 8.2 %]; and DJBL 4.5 % [1.4 % to 7.7 %]). In terms of %EWL, aspiration therapy, fluid-filled balloon, POSE, and DJBL were superior to the control (MD [95 %CI]: 27.3 % [15.3 % to 39.3 %]; 22.4 % [15.4 % to 29.4 %]; 15.3 % [2.5 % to 28.0 %]; and 13.0 % [4.9 % to 21.2], respectively). The gas-filled balloon and botulinum toxin injection did not show a significant difference in %weight loss or %EWL compared with the control. For the fluid-filled balloon, the %EWL and %weight loss tended to decrease after balloon removal at 6 months after the procedure. Conclusion All bariatric endoscopic procedures, except for gas-filled balloon and botulinum toxin injection to the stomach, showed superior short-term efficacy in terms of %weight loss or %EWL compared with lifestyle modification.

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Section: Methodsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Comparative efficacy of bariatric endoscopic procedures in the treatment of morbid obesity: a systematic review and network meta-analysis

et al. 2020

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“…A recent meta-analysis by Jirapinyo, et al [37] in 2018 showed total body weight loss (TBWL) of 18.9% [95% CI, 7.2%-30.6%], and EWL of 36.9% [95% CI, 29.2%-44.6%] at 9 months and a decrease in HbA1c level of 1.3% (95% CI, 1.0%-1.6%) relative to control subjects. The amount of weight loss remained significant at 1 year post-explantation [37] but a recent long term follow-up study revealed that the weight reduction of initial DJBS treatment seems to be diminished after 4 years of follow up [38].…”

Section: Efficacymentioning

confidence: 91%

Role of Small Intestine in Pathophysiology of Obesity and Metabolic Disease and Review of New Endobariatric Procedure Focusing on Small Intestine

Dhruvan¹,

Morgenstern²,

Daxini³

et al. 2020

J Clin Gastroenterol Treat

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Restrictive, Malabsorptive and others [12]. Restrictive procedures act by decreasing the gastric volume by space-occupying devices and/or by suturing or stapling techniques, whereas malabsorptive procedures tend to create malabsorption by preventing the food contact with the duodenum and proximal jejunum [12]. Malabsorptive procedure mimics Roux-n-Y gastric bypass (RYGB) surgery. RYGB exhibits significant hormonal changes after surgery which results in acute and immediate glycemic control via an anti-diabetic weight-independent mechanism, even without significant weight loss after surgery. Therefore, malabsorptive procedure can be considered metabolic procedure because it will help in reducing weight as well as type 2 diabetes mellitus (T2DM). In this review article, we aim to provide an overview on the role of small intestine on obesity and metabolic syndrome and different newer Endo Bariatric procedure focusing on small intestine. Pathophysiology of Small Intestine in the Obesity and T2DM It is very important to understand the role of small intestine in the pathophysiology of obesity in order to understand the effective treatment or endoscopic procedures. Recent insights have revealed the critical physiologic and pathophysiologic role of the small bowel in metabolic homeostasis and its potential role as a driver of obesity, insulin resistance, and subsequent T2DM

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“…AEs occurred in 10.9% of patients requiring early device retrieval ] . Unfortunately, long term follow up study revealed that the weight reduction of initial DJBL treatment seems to be diminished after 4 years of follow up[32]. Due to the results discussed above, the current system fell out of favor but paved the way for second generation DJBSs with atraumatic anchoring and retrieval systems, which are being currently studied in clinical human trials.…”

Section: Small Bowel Endoscopic Bariatric Therapiesmentioning

confidence: 99%

New Era: Endoscopic treatment options in obesity—a paradigm shift

Glass

Chaudhry

Zeeshan

et al. 2019

WJG

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The prevalence of obesity continues to rise, and along with it comes a multitude of health-related consequences. The healthcare community has consistently struggled with providing treatment options to obese patients, in part due to the reluctance of patients in pursuing the more effective (yet invasive) surgical approaches such as sleeve gastrectomy and Rou-en-Y gastric bypass. On the other hand, the less invasive approach such as lifestyle/behavioral interventions and pharmacotherapy (Orlistat, Phenteramine, Phentermine/Topiramate, Locaserin, Naltrexon/Buproprion, and Liraglutide) have very limited efficacy, especially in the morbidly obese patients. Despite our best efforts, the epidemic of obesity continues to rise and pose enormous costs on our healthcare system and society. Bariatric endoscopy is an evolving field generated to combat this epidemic through minimally invasive techniques. These procedures can be performed in an ambulatory setting, are potentially reversible, repeatable, and pose less complications than their invasive surgical counterparts. These modalities are designed to alter gut metabolism by means of space occupation, malabsorption, or restriction. In this review we will discuss different bariatric endoscopic options (such as intragastric balloons, endoscopic sleeve gastroplasty, endoscopic aspiration therapies and gastrointestinal bypass sleeves), their advantages and disadvantages, and suggest a new paradigm where providers may start incorporating this modality in their treatment approach for obese patients.

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Effect of the EndoBarrier Device: a 4-Year Follow-up of a Multicenter Randomized Clinical Trial

Cited by 22 publications

References 23 publications

Comparative efficacy of bariatric endoscopic procedures in the treatment of morbid obesity: a systematic review and network meta-analysis

Comparative efficacy of bariatric endoscopic procedures in the treatment of morbid obesity: a systematic review and network meta-analysis

Role of Small Intestine in Pathophysiology of Obesity and Metabolic Disease and Review of New Endobariatric Procedure Focusing on Small Intestine

New Era: Endoscopic treatment options in obesity—a paradigm shift

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