Research Article
Volume 9 Issue 7 - 2022
Endoscopic Sleeve Gastroplasty Plus Semaglutide Versus Endoscopic Sleeve Gastroplasty Alone for Weight Loss: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study
Anna Carolina Hoff1*, Zadid Haq2, Abdellah Hedjoudje2, Manoel Galvao Neto3, Luiz Gustavo de Quadros4, Sergio Alexandre Barrichello5, Gabriel Cairo Nunes5 and Dilhana Badurdeen6
1Angioskope Clinic, Department of Endobariatrics, São José dos Campos, SP, Brazil
2Department of Medicine, Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
3Head of Bariatric Endoscopy of Mohak, Indore, India
4Kaiser Hospital, São Paulo, Brazil
5Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paolo, Brazil
6Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic Jacksonville, FL, USA
*Corresponding Author: Anna Carolina Hoff, Clinical Director, Division of Endobariatrics, Angioskope Sao Jose dos Campos and São Paulo, Sao Jose dos Campos, SP, Brazil.
Received: June 03, 2022; Published: June 29, 2022




Abstract

Endoscopic sleeve gastroplasty (ESG) is effective for inducing weight loss and treating metabolic co-morbidities of obesity. Semaglutide, a long-acting glucagon-like peptide-1 receptor agonist (GLP-1), produces significant weight loss when combined with lifestyle intervention. In this study, we aim to assess whether adults with overweight and obesity can achieve superior weight loss and metabolic improvement with ESG and semaglutide (ESG-S) compared to ESG alone.

Methods: In this prospective randomized, double-blind, placebo-controlled trial, we enrolled 61 patients with overweight or obesity undergoing ESG at three outpatient clinics in Brazil between June to October 2019. Patients were randomly assigned to treatment with once-weekly injectable semaglutide or an identical placebo pen within 1-month after ESG. 58 patients completed the study. The primary outcome was percent total body weight loss (%TBWL) 12 M after ESG (11 M after initiation of semaglutide). Secondary outcomes were change in percent body fat and hemoglobin A1c (HbA1c) 11 M after initiation of semaglutide.

Results: Comparisons between the two groups showed that patients who received injectable semaglutide within one month of ESG had a superior mean% TBWL at 12 m compared to those who received placebo, 25.21% (SD 2.14%) versus 18.65% (SD 1.44%) (p < 0.001). Additionally, the ESG-S group had a significantly greater reduction in percent body fat mass, 12.69% (SD 4.84%) vs. 9.04% (SD 6.38%), p < 0.001), and lower mean hemoglobin A1c, (4.93 [SD 0.45] vs. 5.33 [SD 0.60]), compared to the ESG group at 12 M.

Conclusion: Combination therapy utilizing injectable semaglutide at 1-month following ESG results in superior weight loss and comorbidities compared to ESG alone, as demonstrated by the decrease in%TBWL, percent body fat and HbA1c at 12m. 

Key points

  • Endoscopic bariatric therapies, while effective, have not achieved bariatric surgery outcomes on their own.
  • Endoscopic sleeve gastroplasty and semaglutide (ESG-S) approached bariatric surgery weight loss outcomes at 12 months.
  • Combination therapy has potential as a less-invasive alternative to bariatric surgery for managing obesity and its complications.

Keywords: Weight Loss; Metabolic Endoscopy; Combination Therapy; Bariatric Endoscopy; Diabetes; Obesity

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Citation: Anna Carolina Hoff., et al. “Endoscopic Sleeve Gastroplasty Plus Semaglutide Versus Endoscopic Sleeve Gastroplasty Alone for Weight Loss: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study”. EC Gastroenterology and Digestive System 9.7 (2022): 54-65.

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