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At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
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Current Obesity Reports
Published in: Current Obesity Reports 2/2016

01-06-2016 | Obesity Treatment (CM Apovian, Section Editor)

Endoscopic Devices for Obesity

Authors: Kartik Sampath, Amreen M. Dinani, Richard I. Rothstein

Published in: Current Obesity Reports | Issue 2/2016

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Abstract

The obesity epidemic, recognized by the World Health Organization in 1997, refers to the rising incidence of obesity worldwide. Lifestyle modification and pharmacotherapy are often ineffective long-term solutions; bariatric surgery remains the gold standard for long-term obesity weight loss. Despite the reported benefits, it has been estimated that only 1% of obese patients will undergo surgery. Endoscopic treatment for obesity represents a potential cost-effective, accessible, minimally invasive procedure that can function as a bridge or alternative intervention to bariatric surgery. We review the current endoscopic bariatric devices including space occupying devices, endoscopic gastroplasty, aspiration technology, post-bariatric surgery endoscopic revision, and obesity-related NOTES procedures. Given the diverse devices already FDA approved and in development, we discuss the future directions of endoscopic therapies for obesity.
Literature
1.
James WP. WHO recognition of the global obesity epidemic. Int J Obes (Lond). 2008;32 Suppl 7:S120–6.CrossRef
2.
Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766–81.CrossRefPubMedPubMedCentral
3.
4.
5.
Selvin E, Parrinello CM, Sacks DB, et al. Trends in prevalence and control of diabetes in the United States, 1988-1994 and 1999-2010. Ann Intern Med. 2014;160(8):517–25.CrossRefPubMedPubMedCentral
6.
Apovian CM. The clinical and economic consequences of obesity. Am J Manag Care. 2013;19(11 Suppl):s219–28.
7.
Dobbs R, Sawers C, Thompson F, et al. How the world could better fight obesity. New York: McKinsey Global Institute, 2014
8.
Sacks FM, Bray GA, Carey VJ, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009;360(9):859–73.CrossRefPubMedPubMedCentral
9.
Wadden TA, Berkowitz RI, Womble LG, et al. Randomized trial of lifestyle modification and pharmacotherapy for obesity. N Engl J Med. 2005;353(20):2111–20.CrossRefPubMed
10.
Wadden TA, Sternberg JA, Letizia KA, et al. Treatment of obesity by very low calorie diet, behavior therapy, and their combination: a five-year perspective. Int J Obes. 1989;13 Suppl 2:39–46.PubMed
11.
12.
13.
14.
Smith SR, Weissman NJ, Anderson CM, Behavioral Modification and Lorcaserin for Overweight and Obesity Management (BLOOM) Study Group, et al. Multicenter, placebo-controlled trial of lorcaserin for weight management. N Engl J Med. 2010;363(3):245–56.CrossRefPubMed
15.
Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient - 2013 update: Cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Surgery for Obesity and Related Diseases 2013. in press.
16.
17.
18.
Maggard-Gibbons M, Maglione M, Livhits M, et al. Bariatric surgery for weight loss and glycemic control in nonmorbidly obese adults with diabetes: a systematic review. JAMA. 2013;309(21):2250–61.CrossRefPubMed
19.
Schauer PR, Bhatt DL, Kirwan JP, STAMPEDE Investigators, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med. 2014;370(21):2002–13.CrossRefPubMed
20.
Sjöström L, Peltonen M, Jacobson P, et al. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA. 2014;311(22):2297–304.CrossRefPubMed
21.
Lassailly G, Caiazzo R, Buob D, et al. Bariatric Surgery Reduces Features of Nonalcoholic Steatohepatitis in Morbidly Obese Patients. Gastroenterology. 2015;149(2):379–88.CrossRefPubMed
22.
23.
Funk LM, Jolles S, Fischer LE, et al. Patient and referring practitioner characteristics associated with the likelihood of undergoing bariatric surgery: a systematic review. JAMA Surg. 2015;150(10):999–1005.CrossRefPubMed
24.
25.
Benjamin SB, Maher KA, Cattau Jr EL, et al. Double-blind controlled trial of the Garren-Edwards gastric bubble: an adjunctive treatment for exogenous obesity. Gastroenterology. 1988;95(3):581–8.PubMed
26.
Hogan RB, Johnston JH, Long BW, et al. A double-blind, randomized, sham-controlled trial of the gastric bubble for obesity. Gastrointest Endosc. 1989;35(5):381–5.CrossRefPubMed
27.
Barkin JS, Reiner DK, Goldberg RI, et al. The effects of morbid obesity and the Garren-Edwards gastric bubble on solid phase gastric emptying. Am J Gastroenterol. 1988;83(12):1364–7.PubMed
28.
Genco A, Bruni T, Doldi SB, et al. BioEnterics intragastric balloon: the Italian experience with 2,515 patients. Obes Surg. 2005;15(8):1161–4.CrossRefPubMed
29.•
Imaz I, Martínez-Cervell C, García-Alvarez EE, et al. Safety and effectiveness of the intragastric balloon for obesity. A meta-analysis. Obes Surg. 2008;18(7):841–6. This meta-analysis describes a summary of 15 studies characterizing the clinical efficacy of the Orbera device for weight loss.CrossRefPubMed
30.
Kotzampassi K, Grosomanidis V, Papakostas P, et al. 500 intragastric balloons: what happens 5 years thereafter? Obes Surg. 2012;22(6):896–903.CrossRefPubMed
31.
Dumonceau JM, François E, Hittelet A, et al. Single vs repeated treatment with the intragastric balloon: a 5-year weight loss study. Obes Surg. 2010;20(6):692–7.CrossRefPubMed
32.
Genco A, Cipriano M, Bacci V, Maselli R, Paone E, Lorenzo M, et al. Intragastric balloon followed by diet vs intragastric balloon followed by another balloon: a prospective study on 100 patients. Obes Surg. 2010;20(11):1496–500. doi:10.​1007/​s11695-010-0231-y.CrossRefPubMed
33.
Zerrweck C, Maunoury V, Caiazzo R, et al. Preoperative weight loss with intragastric balloon decreases the risk of significant adverse outcomes of laparoscopic gastric bypass in super-super obese patients. Obes Surg. 2012;22(5):777–82.CrossRefPubMed
34.
35.
Lopez-Nava G, Bautista-Castaño I, Jimenez-Baños A, Fernandez-Corbelle JP. Dual intragastric balloon: single ambulatory center Spanish experience with 60 patients in endoscopic weight loss management. Obes Surg. 2015;25(12):2263–7.CrossRefPubMed
36.•
Ponce J, Woodman G, Swain J, REDUCE Pivotal Trial Investigators, et al. The REDUCE pivotal trial: a prospective, randomized controlled pivotal trial of a dual intragastric balloon for the treatment of obesity. Surg Obes Relat Dis. 2015;11(4):874–81. This study described the randomized controlled trial demonstrating the efficacy of the ReShape balloon device.CrossRefPubMed
37.
Machytka E, Klvana P, Kornbluth A, et al. Adjustable intragastric balloons: a 12-month pilot trial in endoscopic weight loss management. Obes Surg. 2011;21(10):1499–507.CrossRefPubMedPubMedCentral
38.
Brooks J, Srivastava ED, Mathus-Vliegen EM. One-year adjustable intragastric balloons: results in 73 consecutive patients in the U.K. Obes Surg. 2014;24(5):813–9.CrossRefPubMed
39.
Marinos G, Eliades C, Raman Muthusamy V, et al. Weight loss and improved quality of life with a nonsurgical endoscopic treatment for obesity: clinical results from a 3- and 6-month study. Surg Obes Relat Dis. 2014;10(5):929–34.CrossRefPubMed
40.
Machytka E, Chuttani R, Bojkova M, et al. Elipse™, a procedureless gastric balloon for weight loss: a proof-of-concept pilot study. Obes Surg. 2015;8.
41.
42.
Mion F, Ibrahim M, Marjoux S, et al. Swallowable Obalon® gastric balloons as an aid for weight loss: a pilot feasibility study. Obes Surg. 2013;23(5):730–3.CrossRefPubMed
43.
Nobili V, Corte CD, Liccardo D, et al. Obalon intragastric balloon in the treatment of paediatric obesity: a pilot study. Pediatr Obes. 2015;10(5):e1–4.CrossRefPubMed
44.
Topazian M, Camilleri M, Enders FT, et al. Gastric antral injections of botulinum toxin delay gastric emptying but do not reduce body weight. Clin Gastroenterol Hepatol. 2013;11(2):145–50.CrossRefPubMedPubMedCentral
45.
Bang CS, Baik GH, Shin IS, et al. Effect of intragastric injection of botulinum toxin A for the treatment of obesity: a meta-analysis and meta-regression. Gastrointest Endosc. 2015;81(5):1141–9.CrossRefPubMed
46.
Mion F, Gincul R, Roman S, et al. Tolerance and efficacy of an air-filled balloon in non-morbidly obese patients: results of a prospective multicenter study. Obes Surg. 2007;17(6):764–9.CrossRefPubMed
47.
Giardiello C, Borrelli A, Silvestri E, Antognozzi V, Iodice G, Lorenzo M. Air-filled vs water-filled intragastric balloon: a prospective randomized study. Obes Surg. 2012;22(12):1916–9.CrossRefPubMed
48.
Kumar N, Sahdala HN, Shaikh S, et al. Endoscopic sleeve gastroplasty for primary therapy of obesity: Initial human cases. Gastroenterology. 2014;146:S571–572.CrossRef
49.
Abu Dayyeh BK, Rajan E, Gostout CJ. Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointest Endosc. 2013;78(3):530–5.CrossRefPubMed
50.
Espinós JC, Turró R, Mata A, et al. Early experience with the Incisionless Operating Platform™ (IOP) for the treatment of obesity: the Primary Obesity Surgery Endolumenal (POSE) procedure. Obes Surg. 2013;23(9):1375–83.CrossRefPubMed
51.
Verlaan T, Paulus GF, Mathus-Vliegen EM. Endoscopic gastric volume reduction with a novel articulating plication device is safe and effective in the treatment of obesity (with video). Gastrointest Endosc. 2015;81(2):312–20.CrossRefPubMed
52.
Sullivan S, Stein R, Jonnalagadda S, Mullady D, Edmundowicz S. Aspiration therapy leads to weight loss in obese subjects: a pilot study. Gastroenterology. 2013;145(6):1245–52.CrossRefPubMedPubMedCentral
53.
Fogel R, De Fogel J, Bonilla Y, et al. Clinical experience of transoral suturing for an endoluminal vertical gastroplasty: 1-year follow-up in 64 patients. Gastrointest Endosc. 2008;68(1):51–8.CrossRefPubMed
54.
Brethauer SA, Chand B, Schauer PR, et al. Transoral gastric volume reduction as intervention for weight management: 12-month follow-up of TRIM trial. Surg Obes Relat Dis. 2012;8(3):296–303.CrossRefPubMed
55.
de Jong K, Mathus-Vliegen EM, Veldhuyzen EA, et al. Short-term safety and efficacy of the trans-oral endoscopic restrictive implant system for the treatment of obesity. Gastrointest Endosc. 2010;72(3):497–504.CrossRefPubMed
56.
Familiari P, Costamagna G, Bléro D, et al. Transoral gastroplasty for morbid obesity: a multicenter trial with a 1-year outcome. Gastrointest Endosc. 2011;74(6):1248–58.CrossRefPubMed
57.
Gersin KS, Rothstein RI, Rosenthal RJ, et al. Open-label, sham-controlled trial of an endoscopic duodenojejunal bypass liner for preoperative weight loss in bariatric surgery candidates. Gastrointest Endosc. 2010;71(6):976–82.CrossRefPubMed
58.
de Jonge C, Rensen SS, Verdam FJ, Vincent RP, Bloom SR, Buurman WA, et al. Endoscopic duodenal-jejunal bypass liner rapidly improves type 2 diabetes. Obes Surg. 2013;23(9):1354–60.CrossRefPubMed
59.
de Moura EG, Martins BC, Lopes GS, Orso IR, de Oliveira SL, Galvão Neto MP, et al. Metabolic improvements in obese type 2 diabetes subjects implanted for 1 year with an endoscopically deployed duodenal-jejunal bypass liner. Diabetes Technol Ther. 2012;14(2):183–9.CrossRefPubMed
60.
de Moura EG, Lopes GS, Martins Bda C, Orso IR, Coutinho AM, de Oliveira SL, et al. Effects of Duodenal-Jejunal Bypass Liner (EndoBarrier®) on Gastric Emptying in Obese and Type 2 Diabetic Patients. Obes Surg. 2015;25(9):1618–25.CrossRefPubMed
61.
Rohde U, Hedbäck N, Gluud LL, Vilsbøll T, Knop FK. Effect of the EndoBarrier Gastrointestinal Liner on obesity and type 2 diabetes: Systematic review and meta-analysis. Diabetes Obes Metab. 2015;5.
62.
Betzel B, Koehestanie P, Aarts EO, Dogan K, Homan J, Janssen IM, et al. Safety experience with the duodenal-jejunal bypass liner: an endoscopic treatment for diabetes and obesity. Gastrointest Endosc. 2015;82(5):845–52.CrossRefPubMed
63.
64.
Sandler BJ, Rumbaut R, Swain CP, Torres G, Morales L, Gonzales L, et al. Human experience with an endoluminal, endoscopic, gastrojejunal bypass sleeve. Surg Endosc. 2011;25(9):3028–33.CrossRefPubMed
65.
Sandler BJ, Rumbaut R, Swain CP, et al. One-year human experience with a novel endoluminal, endoscopic gastric bypass sleeve for morbid obesity. Surg Endosc. 2015;29(11):3298–303.CrossRefPubMed
66.
Sauer N, Rösch T, Pezold J. A new endoscopically implantable device (SatiSphere) for treatment of obesity--efficacy, safety, and metabolic effects on glucose, insulin, and GLP-1 levels. Obes Surg. 2013;23(11):1727–33.CrossRefPubMed
67.
68.
Abu Dayyeh BK, Lautz DB, Thompson CC. Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass. Clin Gastroenterol Hepatol. 2011;9:228–33.CrossRefPubMedPubMedCentral
69.
Kumar N, Thompson CC. Comparison of a superficial suturing device with a full-thickness suturing device for transoral outlet reduction (with videos). Gastrointest Endosc. 2014;79(6):984–9.CrossRefPubMed
70.
Abu Dayyeh BK, Jirapinyo P, Weitzner Z, et al. Endoscopic sclerotherapy for the treatment of weight regain after Roux-en-Y gastric bypass: outcomes, complications, and predictors of response in 575 procedures. Gastrointest Endosc. 2012;76(2):275–82.CrossRefPubMedPubMedCentral
71.
Heylen AM, Jacobs A, Lybeer M, et al. The OTSC®-clip in revisional endoscopy against weight gain after bariatric gastric bypass surgery. Obes Surg. 2011;21(10):1629–33.CrossRefPubMed
72.•
Thompson CC, Chand B, Chen YK, et al. Endoscopic suturing for transoral outlet reduction increases weight loss after Roux-en-Y gastric bypass surgery. Gastroenterology. 2013;145(1):129–37. This study represents a randomized sham controlled trial demonstrating the efficacy of the RESTORe suturing system via transoral reduction for weight loss or stabilization in post Roux-en-Y gastric bypass patients.CrossRefPubMed
73.
Horgan S, Jacobsen G, Weiss GD, et al. Incisionless revision of post-Roux-en-Y bypass stomal and pouch dilation: multicenter registry results. Surg Obes Relat Dis. 2010;6(3):290–5.CrossRefPubMed
74.
Khashab MA, Kumbhari V, Grimm IS, et al. EUS-guided gastroenterostomy: the first U.S. clinical experience (with video). Gastrointest Endosc. 2015;82(5):932–8.CrossRefPubMed
75.
von Renteln D, Vassiliou MC, McKenna D, Suriawinata AA, Swain CP, Rothstein RI. Endoscopic vs. laparoscopic gastrojejunostomy for duodenal obstruction: a randomized study in a porcine model. Endoscopy. 2012;44(2):161–8.CrossRef
76.
Ryou M, Agoston AT, Thompson CC. Endoscopic intestinal bypass creation using self-assembling magnets in a porcine model. Gastrointest Endosc. 2015 Oct 29. pii: S0016-5107(15)03039-4.
77.
Camilleri M, Toouli J, Herrera MF, et al. Intra-abdominal vagal blocking (VBLOC therapy): clinical results with a new implantable medical device. Surgery. 2008;143(6):723–31.CrossRefPubMed
78.
Sarr MG, Billington CJ, Brancatisano R, EMPOWER Study Group, et al. The EMPOWER study: randomized, prospective, double-blind, multicenter trial of vagal blockade to induce weight loss in morbid obesity. Obes Surg. 2012;22(11):1771–82.CrossRefPubMed
79.
Ikramuddin S, Blackstone RP, Brancatisano A, et al. Effect of reversible intermittent intra-abdominal vagal nerve blockade on morbid obesity: the ReCharge randomized clinical trial. JAMA. 2014;312(9):915–22.CrossRefPubMed
80.
Shikora SA, Wolfe BM, Apovian CM, et al. Sustained weight loss with vagal nerve blockade but not with sham: 18-month results of the ReCharge trial. J Obes. 2015;2015:365604.CrossRefPubMedPubMedCentral
81.
Weichman K, Ren C, Kurian M, et al. The effectiveness of adjustable gastric banding: a retrospective 6-year U.S. follow-up study. Surg Endosc. 2011;25(2):397–403.CrossRefPubMed
82.
Fan J, Xu JH, Wang J, et al. Effects of laparoscopic adjustable gastric banding on weight loss, metabolism, and obesity-related comorbidities: 5-year results in China. Obes Surg. 2014;24(6):891–6.CrossRefPubMed
83.
O’Brien PE, MacDonald L, Anderson M, et al. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg. 2013;257(1):87–94.CrossRefPubMed
84.
Cobourn C, Chapman MA, Ali A, et al. Five-year weight loss experience of outpatients receiving laparoscopic adjustable gastric band surgery. Obes Surg. 2013;23(7):903–10.CrossRefPubMedPubMedCentral
85.
Parikh MS, Laker S, Weiner M, et al. Objective comparison of complications resulting from laparoscopic bariatric procedures. J Am Coll Surg. 2006;202(2):252–61.CrossRefPubMed
86.
Chakravarty PD, McLaughlin E, Whittaker D, et al. Comparison of laparoscopic adjustable gastric banding (LAGB) with other bariatric procedures; a systematic review of the randomized controlled trials. Surgeon. 2012;10(3):172–82.CrossRefPubMed
87.
Roslin MS, Brauner RH, Dixon JA. A randomized controlled study of Scientific Intake’s Sensor Monitored Alimentary Restriction Therapy (SMART™) Device. [Abstract]. Obesity Society Annual Meeting, 2009.
88.
McGee TL, Grima MT, Hewson ID, et al. First Australian experiences with an oral volume restriction device to change eating behaviors and assist with weight loss. Obesity. 2012;20(1):126–33.CrossRefPubMed
Metadata
Title
Endoscopic Devices for Obesity
Authors
Kartik Sampath
Amreen M. Dinani
Richard I. Rothstein
Publication date
01-06-2016
Publisher
Springer US
Published in
Current Obesity Reports / Issue 2/2016
Electronic ISSN: 2162-4968
DOI
https://doi.org/10.1007/s13679-016-0217-8

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Obesity Clinical Trial Summary

At a glance: The STEP trials

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A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

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