P4885 - Combination Therapy of Glucagon-Like-Peptide-1 Receptor Agonists and Endoscopic Gastric Plication in Obesity Population: A Meta-Analysis

Noppachai Siranart, MD¹, Patavee Pajareya, MD², Rinrada Worapongpaiboon, ², Chanattha Thimphitthaya, MD³, Natchaya Polpichai, MD⁴, Somkiat Phutinart, ⁵, Emily Shu-Yen Chan, MD, MSc⁴, Panisara Fangsaard, MD⁶, Pojsakorn Danpanichkul, MD⁷, Ponthakorn Kaewkanha, MD^8
1Brigham and Women's Hospital, Boston, MA; ²King Chulalongkorn Memorial Hospital, Bangkok, Krung Thep, Thailand; ³University of Texas Southwestern Medical Center, Dallas, TX; ⁴Weiss Memorial Hospital, Chicago, IL; ⁵Chulalongkorn University, Bangkok, Krung Thep, Thailand; ⁶Bassett Medical Center, Cooperstown, NY; ⁷Texas Tech University Health Sciences Center, Lubbock, TX; ⁸King Chulalongkorn Memorial Hospital, Phayathai, Krung Thep, Thailand

Introduction: Recent advancements in obesity treatment have demonstrated promising results with both endoscopic gastric plication (EGP) and glucagon-like-peptide-1 receptor agonists (GLP-1 RAs). Combining these two therapies may further enhance therapeutic outcomes. This study evaluates the efficacy and safety of the combination therapy (EGP+GLP-1 RAs) in patients with obesity.

Methods: A literature search was conducted up until May 2024 to select studies comparing the outcomes between the combination therapy and EGP monotherapy group. The primary endpoint was total body weight loss (%TBWL). Secondary endpoints were excess weight loss (%EWL) and adverse events. A random-effects model and subgroup analysis were performed to pool mean differences and 95% confidence intervals (CI).

Results: Out of 24,381 search results, a total of 4 studies were included, comprising 1,505 obese adult patients (1,378 EGP, 127 EGP+GLP-1 RAs). In the EGP+GLP-1 RAs group, the patients reached 20.05% [95% CI: 9.38-30.73] TBWL, 73.19% [95% CI: 19.86-126.53] EWL at the 6-month post-intervention, and 16.50% [95% CI: -4.46 to 37.46] TBWL at the 12-month post-intervention. In the EGP group, the patients reached 16.56% [95% CI: 9.28-23.85] TBWL, 57.40% [95% CI: 38.47-76.33] EWL at the 6-month post-intervention, and 13.49% [95% CI: -34.77 to 61.76] TBWL at the 12-month post-intervention. EGP+GLP-1 RAs seem to have higher and long-term durability for weight loss outcome although, insignificant differences were noted between both groups. Subgroup analysis by type of GLP-1 RAs showed that semaglutide seems to have the highest efficacy for weight reduction with 22.01% TBWL, followed by liraglutide with 18.26% TBWL, and dulaglutide with 15.80% TBWL at the 6-month post-intervention. The statistics showed no significant differences between these medications (p = 0.78). Both groups had a low rate of adverse events, with no difference between groups. Most common adverse event is mild nausea in patients who received GLP-1 RAs.

Discussion: GLP-1 RAs are safe when combined with EGP, resulting in significant and sustainable weight loss.



Disclosures:


Noppachai Siranart, MD¹, Patavee Pajareya, MD², Rinrada Worapongpaiboon, ², Chanattha Thimphitthaya, MD³, Natchaya Polpichai, MD⁴, Somkiat Phutinart, ⁵, Emily Shu-Yen Chan, MD, MSc⁴, Panisara Fangsaard, MD⁶, Pojsakorn Danpanichkul, MD⁷, Ponthakorn Kaewkanha, MD⁸. P4885 - Combination Therapy of Glucagon-Like-Peptide-1 Receptor Agonists and Endoscopic Gastric Plication in Obesity Population: A Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.