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Published in: Obesity Surgery 9/2018

01-09-2018 | Original Contributions

Fluid-Filled Versus Gas-Filled Intragastric Balloons as Obesity Interventions: a Network Meta-analysis of Randomized Trials

Authors: Fateh Bazerbachi, Samir Haffar, Tarek Sawas, Eric J. Vargas, Ravinder Jeet Kaur, Zhen Wang, Larry J. Prokop, M. Hassan Murad, Barham K. Abu Dayyeh

Published in: Obesity Surgery | Issue 9/2018

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Abstract

Background

Four commercially available intragastric balloons have been used for the management of obesity and underwent randomized controlled trials (RCTs), and we aimed to compare them using a network meta-analysis approach.

Methods

Several databases were queried from inception to May 26, 2017, and we included RCTs enrolling patients treated with Orbera, Heliosphere, ReShape Duo, and Obalon compared with another balloon, sham, or open-label control group. Two investigators independently abstracted data. A random effects frequentist network meta-analysis and relative ranking of agents using surface under the cumulative ranking probabilities were performed.

Results

We included 15 trials at low risk of bias (only two were head-to-head). Compared to control groups, the two fluid-filled devices were associated with significant outcome (% total body weight loss) at 6 months: Orbera, 6.72% (95% CI, 5.55, 7.89) and ReShape Duo 4% (95% CI 2.69, 5.31). Only one of the two gas-filled devices was associated with significant outcome at 6 months: Obalon 3.3% (95% CI 2.30, 4.30), and not the second: Heliosphere 6.71% (95% CI − 0.82, 14.23). Fluid-filled devices had the highest likelihood of superiority in achieving the outcome at 6 months (96.8%) and at 12 months (96.6%). The quality of evidence was high for comparisons against control.

Conclusions

Fluid-filled balloons are more likely to produce weight loss compared to gas-filled balloons or lifestyle intervention. However, they may be associated with a higher rate of intolerance and early removal. This information will aid clinicians in device selection and engaging patients in shared decision-making.
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Metadata
Title
Fluid-Filled Versus Gas-Filled Intragastric Balloons as Obesity Interventions: a Network Meta-analysis of Randomized Trials
Authors
Fateh Bazerbachi
Samir Haffar
Tarek Sawas
Eric J. Vargas
Ravinder Jeet Kaur
Zhen Wang
Larry J. Prokop
M. Hassan Murad
Barham K. Abu Dayyeh
Publication date
01-09-2018
Publisher
Springer US
Published in
Obesity Surgery / Issue 9/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3227-7

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