Systematic Reviews and Meta-analysesEffect of Endoscopic Bariatric and Metabolic Therapies on Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis
Section snippets
Data Sources and Search Strategy
The search strategy, study eligibility criteria, selection process, data collection process, primary and secondary outcomes, and analyses were defined a priori and are described below. We searched 4 databases, MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials, from inception to December 2020 without language or study design restrictions. The search was designed and conducted by a medical librarian with input from study investigators. An extensive search
Search Results
A total of 4994 potential studies were identified, 501 of which were duplicates. After title and abstract review, 4122 studies were excluded, leaving 371 articles for full-text review. Full-text review resulted in 18 articles that satisfied all criteria and were therefore included in the systematic review and meta-analysis (Figure 1).
All 18 studies with a total of 863 patients reported at least one liver-related outcome after EBMT. Of these, 3 studies (17%) were RCTs (1 study comparing IGB vs
Discussion
This comprehensive systematic review and meta-analysis investigates the effect of the currently FDA-approved EBMTs on liver outcomes. Our study demonstrates that EBMTs are associated with significant improvement in all major NAFLD surrogates including liver fibrosis. In addition, all surrogate markers of insulin resistance including HOMA-IR, fasting glucose, and fasting insulin significantly improve, suggesting possible mechanisms of how EBMTs affect NAFLD improvement. On meta-regression, age,
CRediT Authorship Contributions
Pichamol Jirapinyo (Conceptualization: Lead; Data curation: Lead; Formal analysis: Lead; Methodology: Lead; Project administration: Lead; Software: Lead; Supervision: Equal; Writing – original draft: Lead; Writing – review & editing: Lead)
Thomas R. McCarty (Data curation: Supporting; Methodology: Supporting; Writing – review & editing: Supporting)
Russell D. Dolan (Data curation: Supporting)
Raj Shah (Methodology: Supporting; Writing – review & editing: Supporting)
Christopher C. Thompson, MD, MS
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2023, Annals of HepatologyCitation Excerpt :However, only five have been approved by the FDA based on randomized controlled trials. They include gastric and duodenal devices and techniques such as: intragastric balloons (IGB), endoscopic sleeve gastroplasty (ESG), primary obesity surgery endoluminal (POSE), aspiration therapy and transpyloric shuttle [39]. In a recent systematic review and metanalysis of 18 studies with 863 patients treated with these BET techniques, it was reported weight reduction of 14.5% at a 6 month follow- up.
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Conflicts of interest These authors disclose the following: P. Jirapinyo: Apollo Endosurgery– research support; Fractyl - research support; GI Dynamics – research support, consultant (consulting fees); Endogastric Solutions – consultant; ERBE - consultant (consulting fees). C. C. Thompson: Apollo Endosurgery – consultant/research support (consulting fees/institutional research grants); Aspire Bariatrics – research support (institutional research grant); BlueFlame Healthcare Venture Fund – general partner; Boston Scientific – consultant (consulting fees); Covidien/Medtronic – consultant (consulting fees); EnVision Endoscopy (board member); Fractyl – consultant/advisory board member (consulting fees); GI Dynamics – consultant (consulting fees)/research support (institutional research grant); GI Windows – ownership interest; Olympus/Spiration – consultant (consulting fees)/research support (equipment loans); Spatz – research support (institutional research grant); USGI Medical – consultant (consulting fees)/advisory board member (consulting fees)/research support (research grant). The remaining authors disclose no conflicts.