Comparison of the Efficacy and Safety of the FDA-approved Intragastric Balloon Systems in a Clinical Setting.


Journal

Journal of clinical gastroenterology
ISSN: 1539-2031
Titre abrégé: J Clin Gastroenterol
Pays: United States
ID NLM: 7910017

Informations de publication

Date de publication:
01 07 2023
Historique:
received: 11 10 2021
accepted: 30 03 2022
medline: 16 6 2023
pubmed: 24 5 2022
entrez: 23 5 2022
Statut: epublish

Résumé

The gas-filled intragastric balloon (IGB) system (Obalon) and the fluid-filled IGB system (Orbera) are the current FDA-approved IGB systems to treat obesity; however, they have not been previously compared in clinical practice. The aims of this study were to compare their efficacy, tolerance, and safety in a clinical setting. This is a retrospective cohort study of consecutive patients treated with the gas-filled IGB or fluid-filled IGB between October 2015 and May 2020 at 2 academic centers. The primary endpoints included percent total body weight loss at balloon removal in patients who completed at least 20 weeks of therapy, the difference in adverse events that required urgent evaluation or hospitalization, and early removal in the 2 groups. A total of 87 patients underwent successful IGB placement (gas-filled IGB n=57, age 48.9±8.8, body mass index 35.5±5 kg/m 2 ; fluid-filled IGB n=30, age 49.2±14.3, body mass index 38.8±6 kg/m 2 ). Eleven patients underwent early device removal. There were no differences in percent total body weight loss at balloon removal and 12 months between the balloon systems ( P =0.39). Patients who received the fluid-filled IGB were more likely to require urgent evaluation or treatment, require hospital stay >24 hours, and need early balloon system removal compared with patients treated with the gas-filled IGB. In this 2-center cohort, both FDA-approved gastric balloon systems had the same effectiveness, but the gas-filled IGB had fewer serious adverse events and better tolerability than the fluid-filled IGB.

Sections du résumé

BACKGROUND AND AIMS
The gas-filled intragastric balloon (IGB) system (Obalon) and the fluid-filled IGB system (Orbera) are the current FDA-approved IGB systems to treat obesity; however, they have not been previously compared in clinical practice. The aims of this study were to compare their efficacy, tolerance, and safety in a clinical setting.
MATERIALS AND METHODS
This is a retrospective cohort study of consecutive patients treated with the gas-filled IGB or fluid-filled IGB between October 2015 and May 2020 at 2 academic centers. The primary endpoints included percent total body weight loss at balloon removal in patients who completed at least 20 weeks of therapy, the difference in adverse events that required urgent evaluation or hospitalization, and early removal in the 2 groups.
RESULTS
A total of 87 patients underwent successful IGB placement (gas-filled IGB n=57, age 48.9±8.8, body mass index 35.5±5 kg/m 2 ; fluid-filled IGB n=30, age 49.2±14.3, body mass index 38.8±6 kg/m 2 ). Eleven patients underwent early device removal. There were no differences in percent total body weight loss at balloon removal and 12 months between the balloon systems ( P =0.39). Patients who received the fluid-filled IGB were more likely to require urgent evaluation or treatment, require hospital stay >24 hours, and need early balloon system removal compared with patients treated with the gas-filled IGB.
CONCLUSION
In this 2-center cohort, both FDA-approved gastric balloon systems had the same effectiveness, but the gas-filled IGB had fewer serious adverse events and better tolerability than the fluid-filled IGB.

Identifiants

pubmed: 35604348
doi: 10.1097/MCG.0000000000001718
pii: 00004836-202307000-00007
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

578-585

Informations de copyright

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Références

Hales CM, Fryar CD, Carroll MD, et al. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016. JAMA. 2018;319:1723–1725.
Schnurr TM, Jakupović H, Carrasquilla GD, et al. Obesity, unfavourable lifestyle and genetic risk of type 2 diabetes: a case-cohort study. Diabetologia. 2020;63:1324–1332.
Lu Y, Hajifathalian K, Ezzati M, et al. Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1·8 million participants. Lancet (London, England). 2014;383:970–983.
Li L, Liu DW, Yan HY, et al. Obesity is an independent risk factor for non-alcoholic fatty liver disease: evidence from a meta-analysis of 21 cohort studies. Obes Rev. 2016;17:510–519.
Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348:1625–1638.
Tamara A, Tahapary DL. Obesity as a predictor for a poor prognosis of COVID-19: a systematic review. Diabetes Metab Syndr. 2020;14:655–659.
Kim DD, Basu A. Estimating the medical care costs of obesity in the United States: systematic review, meta-analysis, and empirical analysis. Value Health. 2016;19:602–613.
Abu Dayyeh BK. Intragastric balloons for obesity management. Gastroenterol Hepatol. 2017;13:737–739.
Neto MG, Silva LB, Grecco E, et al. Brazilian Intragastric Balloon Consensus Statement (BIBC): practical guidelines based on experience of over 40,000 cases. Surg Obes Relat Dis. 2018;14:151–159.
Courcoulas A, Abu Dayyeh BK, Eaton L, et al. Intragastric balloon as an adjunct to lifestyle intervention: a randomized controlled trial. Int J Obes (Lond). 2017;41:427–433.
Sullivan S, Swain J, Woodman G, et al. Randomized sham-controlled trial of the 6-month swallowable gas-filled intragastric balloon system for weight loss. Surg Obes Relat Dis. 2018;14:1876–1889.
@US_FDA. Weight-loss and weight-management devices. FDA. 2020. Available at: https://www.fda.gov/medical-devices/products-and-medical-procedures/weight-loss-and-weight-management-devices#factors . Accessed March 11, 2021.
Muniraj T, Day LW, Teigen LM, et al. AGA clinical practice guidelines on intragastric balloons in the management of obesity. Gastroenterology. 2021;160:1799–1808.
Baron TH, Ryan JL. Handbook of Gastroenterologic Procedures, 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2020.
Bennett MC, Badillo R, Sullivan S. Endoscopic management. Gastroenterol Clin. 2016;45:673–688.
US_FDA. Obalon Balloon System_Summary of Safety and Effectiveness Data (SSED) 2016. 2020. Available at: https://www.accessdata.fda.gov/cdrh_docs/pdf16/P160001b.pdf . Accessed March 11, 2021.
US_FDA. ORBERA Intragastric Balloon System Summary of Safety and Effectiveness Data (SSED) 2015. 2020. Available at: https://www.accessdata.fda.gov/cdrh_docs/pdf14/P140008b.pdf . Accessed March 11, 2021.
US_FDA. Obalon Balloon System_Instructions for Use (DFU). 2016. Available at: https://www.accessdata.fda.gov/cdrh_docs/pdf16/p160001d.pdf . Accessed March 11, 2021.
US_FDA. ORBERA Intragastric Balloon System_Directions for Use (DFU). 2015. Available at: https://www.accessdata.fda.gov/cdrh_docs/pdf14/P140008c.pdf . Accessed March 11, 2021.
Yanovski SZ, Marcus MD, Wadden TA, et al. The Questionnaire on Eating and Weight Patterns-5: an updated screening instrument for binge eating disorder. Int J Eat Disord. 2015;48:259–261.
Levis B, Benedetti A, Thombs BD. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis. BMJ. 2019;365:l1476.
Moore RL, Seger MV, Garber SM, et al. Clinical safety and effectiveness of a swallowable gas-filled intragastric balloon system for weight loss: consecutively treated patients in the initial year of U.S. commercialization. Surg Obes Relat Dis. 2019;15:417–423.
Gaur S, Levy S, Mathus-Vliegen L, et al. Balancing risk and reward: a critical review of the intragastric balloon for weight loss. Gastrointest Endosc. 2015;81:1330–1336.
Fuller NR, Pearson S, Lau NS, et al. An intragastric balloon in the treatment of obese individuals with metabolic syndrome: a randomized controlled study. Obesity (Silver Spring). 2013;21:1561–1570.
Vargas EJ, Pesta CM, Bali A, et al. Single fluid-filled intragastric balloon safe and effective for inducing weight loss in a real-world population. Clin Gastroenterol Hepatol. 2018;16:1073–1080.e1.
Moore RL, Eaton L, Ellner J. Safety and effectiveness of an intragastric balloon as an adjunct to weight reduction in a post-marketing clinical setting. Obes Surg. 2020;30:4267–4274.
Sullivan S, Swain JM, Woodman G, et al. Randomized sham-controlled trial evaluating efficacy and safety of endoscopic gastric plication for primary obesity: The ESSENTIAL trial. Obesity (Silver Spring, Md). 2017;25:294–301.
Bazerbachi F, Vargas EJ, Abu Dayyeh BK. Endoscopic bariatric therapy: a guide to the intragastric balloon. Am J Gastroenterol. 2019;114:1421–1431.
Bazerbachi F, Haffar S, Sawas T, et al. Fluid-filled versus gas-filled intragastric balloons as obesity interventions: a network meta-analysis of randomized trials. Obes Surg. 2018;28:2617–2625.
Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384:989–1002.
van Baar ACG, Holleman F, Crenier L, et al. Endoscopic duodenal mucosal resurfacing for the treatment of type 2 diabetes mellitus: one year results from the first international, open-label, prospective, multicentre study. Gut. 2020;69:295–303.
Farina MG, Baratta R, Nigro A, et al. Intragastric balloon in association with lifestyle and/or pharmacotherapy in the long-term management of obesity. Obes Surg. 2012;22:565–571.
Badurdeen D, Hoff AC, Barrichello S, et al. Efficacy of liraglutide to prevent weight regain after retrieval of an adjustable intra-gastric balloon—a case-matched study. Obes Surg. 2021;31:1204–1213.
Dayyeh BKA, Kumar N, Edmundowicz SA, et al. ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc. 2015;82:425–438.e5.

Auteurs

Eric Swei (E)

Division of Gastroenterology, University of Colorado School of Medicine, Aurora, CO.

Aymen Almuhaidb (A)

Division of Gastroenterology.

Shelby Sullivan (S)

Division of Gastroenterology, University of Colorado School of Medicine, Aurora, CO.

Abdullah Al-Shahrani (A)

Division of Gastroenterology.

Felicia R D'Souza (FR)

Division of Hospital Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO.

Osama Altayar (O)

Division of Gastroenterology.

Suzanne Bell (S)

Division of Gastroenterology.

Rachel Maday (R)

Division of Gastroenterology.

Mihir S Wagh (MS)

Division of Gastroenterology, University of Colorado School of Medicine, Aurora, CO.

Dan Mullady (D)

Division of Gastroenterology.

Michael Bennett (M)

Division of Gastroenterology.

Dayna Early (D)

Division of Gastroenterology.

Vladimir Kushnir (V)

Division of Gastroenterology.

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