Revisional endoscopic sleeve gastroplasty versus semaglutide and tirzepatide for weight recidivism after sleeve gastrectomy.

IF 2.2 Q3 ENDOCRINOLOGY & METABOLISM

Clinical Obesity Pub Date : 2025-02-05 DOI:10.1111/cob.70001

Firas Bahdi, Sagar Shah, Fadi Dahoud, Maryam Farooq, Philip Kozan, Stephen Kim, Alireza Sedarat, Na Shen, Adarsh Thaker, Jennifer M Kolb, Erik Dutson, V Raman Muthusamy, Danny Issa

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引用次数: 0

Abstract

Background and aims: Weight recidivism following sleeve gastrectomy (SG) is common. Adjuvant treatments include new glucagon-like peptide 1 and glucose-dependent insulinotropic peptide receptor agonists (GLP1/GIP-RA) or revisional endoscopic sleeve gastroplasty (R-ESG). We here compare the outcomes of these treatments.

Methods: A retrospective study of patients ≥18 years with prior SG treated with semaglutide, tirzepatide or R-ESG for weight recidivism between January 2019 and 2023 at large academic centre. Primary outcomes were total body weight loss (TBWL) and adverse events (AEs). Secondary outcomes were changes in metabolic parameters. Tertiary outcome was to compare GLP1/GIP-RA outcomes in SG patients to matched patients with intact stomach.

Results: Our study included 68 (prior SG + GLP1/GIP-RA) and 22 (prior SG + R-ESG). R-ESG offered higher TBWL% than GLP1/GIP-RA at 3 (11.2% vs. 4.3%, p < .001), 6 (13.5% vs. 6.8%, p < .001) and 12 months (13.4% vs. 9.2%, p = .07) with no significant difference in AEs or change in metabolic parameters. On subgroup analysis, tirzepatide achieved similar 12-months TBWL% as R-ESG (13.2% vs. 13.4%, p = .9) and significantly more than semaglutide (13.2% vs. 8.1%, p = .04). Compared to patients with intact stomach (n = 87), GLP1/GIP-RA achieved significantly lower TBWL% in patients with prior SG at 3 (4.3% vs. 5.7%, p = .02), 6 (6.8% vs. 9.2%, p = .02) and 12 months (9.2% vs. 12.7%, p = .03). Medication refills were difficult in 41.3% of patients.

Conclusions: In a single-centre real-world experience study, R-ESG and tirzepatide appear to offer more weight loss than semaglutide in SG patients with weight recidivism although GLP1/GIP-RA were underdosed. GLP1/GIP-RA achieved higher weight loss in patients with intact stomach than those with prior SG.

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来源期刊

Clinical Obesity ENDOCRINOLOGY & METABOLISM-

CiteScore

5.90

自引率

3.00%

发文量

期刊介绍： Clinical Obesity is an international peer-reviewed journal publishing high quality translational and clinical research papers and reviews focussing on obesity and its co-morbidities. Key areas of interest are: • Patient assessment, classification, diagnosis and prognosis • Drug treatments, clinical trials and supporting research • Bariatric surgery and follow-up issues • Surgical approaches to remove body fat • Pharmacological, dietary and behavioural approaches for weight loss • Clinical physiology • Clinically relevant epidemiology • Psychological aspects of obesity • Co-morbidities • Nursing and care of patients with obesity.