Efficacy and Safety of Intragastric Balloon Therapy Compared to a Multidisciplinary Weight Loss Program (OPTIFAST) in a Real-World Population: A Propensity Score Matching Analysis.

IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Obesity Facts Pub Date : 2023-01-01 DOI:10.1159/000524895
Miriam Oster, Nathalena Hein, Aysegül Aksan, Heiner Krammer, Sophia Theodoridou, Jürgen Stein
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引用次数: 2

Abstract

Introduction: Obesity is a major global health problem associated with comorbidities such as diabetes, cardiovascular disease, and cancer. Bariatric surgery is recognized to be the most effective weight loss intervention, but it is highly invasive and costly and can have serious side effects. Intragastric balloon (IGB) placement by endoscopy and hypocaloric diets are among a number of techniques that have been used in patients unsuitable for, or unwilling to undergo, obesity surgery. In this study, we compared the efficacy, safety, and cost-effectiveness of the hypocaloric OPTIFAST program (OPT) with endoscopic IGB placement for weight loss.

Methods: In this retrospective observational cohort propensity score-weighted comparison (performed May 2014 to December 2020), participants with a BMI of 30-55 kg/m2, aged 18-70 years, were randomized to OPT or IGB for 26 weeks, followed by a weight maintenance phase. Patients were matched according to age, gender, and BMI. The study outcomes were percentage excess body weight lost, total body weight lost (TBWL), and percentage TBWL (%TBWL).

Results: A total of 148 participants (75% of those randomized; 74 OPT, 74 IGB) made up the ITT population. Mean age was 44.1 ± 10.4 years, and the patients were predominantly female (77%). Baseline BMI was 44.1 ± 10.4 kg/m2. At 26 weeks, %TBWL in the OPT group was 19.6 ± 6.8% versus 11.9 ± 6.7% for IGB (p < 0.001). At 52 weeks, %TBWL for OPT was 18.2 ± 9.0% versus 12.0 ± 6.6% for IGB (p < 0.001). The OPT cohort also experienced significantly fewer adverse events compared with the IGB group.

Conclusion: IGB placement and OPT induce clinically meaningful weight loss. However, OPT appears to induce clinically superior weight loss and has economic advantages through lower rates of complications and adverse events.

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在现实世界人群中,胃内球囊治疗与多学科减肥计划(OPTIFAST)的疗效和安全性比较:倾向评分匹配分析。
肥胖是一个主要的全球性健康问题,与糖尿病、心血管疾病和癌症等合并症有关。减肥手术被认为是最有效的减肥干预措施,但它是高度侵入性的,昂贵的,并且可能有严重的副作用。通过内窥镜和低热量饮食植入胃内球囊(IGB)是用于不适合或不愿接受肥胖手术的患者的许多技术之一。在这项研究中,我们比较了低热量OPTIFAST计划(OPT)与内镜下IGB放置减肥的疗效、安全性和成本效益。方法:在这项回顾性观察队列倾向评分加权比较中(2014年5月至2020年12月进行),BMI为30-55 kg/m2的参与者,年龄18-70岁,随机分为OPT或IGB组,为期26周,随后是体重维持阶段。患者根据年龄、性别和BMI进行匹配。研究结果为超重体重减轻百分比、总体重减轻百分比(TBWL)和体重减轻百分比(%TBWL)。结果:共有148名参与者(75%随机;74名OPT, 74名IGB)组成了ITT的人口。平均年龄44.1±10.4岁,以女性为主(77%)。基线BMI为44.1±10.4 kg/m2。26周时,OPT组的TBWL %为19.6±6.8%,IGB组为11.9±6.7% (p < 0.001)。52周时,OPT组的TBWL为18.2±9.0%,IGB组为12.0±6.6% (p < 0.001)。与IGB组相比,OPT组的不良事件也明显减少。结论:IGB放置和OPT可诱导有临床意义的体重减轻。然而,OPT似乎能诱导临床上较好的减肥效果,并且由于并发症和不良事件发生率较低而具有经济优势。
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来源期刊
Obesity Facts
Obesity Facts 医学-内分泌学与代谢
CiteScore
6.80
自引率
5.60%
发文量
77
审稿时长
6-12 weeks
期刊介绍: ''Obesity Facts'' publishes articles covering all aspects of obesity, in particular epidemiology, etiology and pathogenesis, treatment, and the prevention of adiposity. As obesity is related to many disease processes, the journal is also dedicated to all topics pertaining to comorbidity and covers psychological and sociocultural aspects as well as influences of nutrition and exercise on body weight. The editors carefully select papers to present only the most recent findings in clinical practice and research. All professionals concerned with obesity issues will find this journal a most valuable update to keep them abreast of the latest scientific developments.
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