1. Approximately three-quarters (77%) of patients undergoing endoscopic sleeve gastroscopy with lifestyle changes achieved a 25% or greater reduction in excess body weight.
2. There were 3 (2%) serious ESG-related adverse events, none leading to further surgery, intensive care, or death.
Evidence Rating Level: 1 (excellent)
Research overview: Currently available bariatric treatment options have many limitations, including the invasiveness of bariatric surgery and the subjective effects of lifestyle changes. Endoscopic sleeve gastroplasty (ESG) is a reversible endoscopic procedure and to date there are no large randomized trials evaluating its efficacy and safety in the management of obesity. The MERIT study enrolled eligible participants and randomly assigned them to either ESG plus moderate-intensity lifestyle changes or moderate-intensity lifestyle changes only. After 52 weeks, the rate of excess weight loss in the ESG group was significantly higher than in the control group: more than three-quarters of his He achieved his EWL of over 25%. This weight loss was maintained in the majority of his ESG group at 104-week follow-up. The procedure was well tolerated with only 3 serious adverse events (2%) and none leading to further surgery, intensive care or death. Limitations of this study include the lack of a ‘sham’ control inherent in the nature of the intervention. Nevertheless, this study provides promising results for non-conservative management options for obesity.
Click to read The Lancet study
Related reading: Endoscopic sleeve gastroplasty for obesity: a multicenter study of 248 patients with 24 months of follow-up
detail [randomized control trial]: MERIT was held at nine US centers. This study enrolled individuals aged 21–65 years with a BMI of 30–40 kg/m2. Participants had to have a history of previous failure with non-surgical weight loss methods. Participants were excluded if they had a history of gastrointestinal surgery. After enrollment, participants were asked to undergo endoscopic sleeve gastroplasty (ESG) and moderate-intensity lifestyle changes (n = 85) or moderate-intensity lifestyle changes alone (control) during his 52-week period. , n = 124) in a 1:1.5 ratio. The primary outcome measured was the percentage of excess weight loss at 52 weeks. EWL was calculated by the formula: (weight loss/baseline excess weight)×100. Baseline excess weight was defined as baseline index weight minus ideal weight (25 kg/m2).
At week 52, the mean percentage of EWL was 49.2% in the ESG group compared to 3.2% in the control group (p<0.0001). Seventy-seven percent of participants in the ESG group achieved ≥25% of their EWL at 52 weeks compared with 12% in the control group (p < 0.0001). Further follow-up at 104 weeks showed that 68% of the ESG group maintained his EWL above 25%. Patients undergoing ESG requiring surgical, endoscopic, or radiological intervention had three serious adverse events (2%). The three events were cases of abdominal abscess, upper gastrointestinal bleeding, and malnutrition requiring ESG reversal. There were no ESG-related deaths.
Image: PD
©2022 2 Minute Medicine Co., Ltd. all rights reserved. No work may be reproduced without the express written consent of 2 Minute Medicine Co., Ltd. Inquiries about license hereNone of the articles should be construed as medical advice, nor should they be construed as such by the authors or 2 Minute Medicine, Inc.
.
