P4494 - ESG Combined With Pharmacotherapy is Associated With Greater Patient Visit Compliance Compared to ESG Alone

Jeong Hoon Kim, MD¹, Jade Wang, MD¹, Kamal Hassan, MD², Enad Dawod, MD¹, Patrick Magahis, BA¹, Anam Rizvi, MD¹, Cynthia O. Akagbosu, MD, MA³, Mark Hanscom, MD¹, SriHari Mahadev, MD³, David L. Carr-Locke, MA, MD, FACG¹, Reem Sharaiha, MD¹, Kartik Sampath, MD^1
1Weill Cornell Medicine, New York, NY; ²New York-Presbyterian/Queens, New York, NY; ³New York-Presbyterian / Weill Cornell Medical Center, New York, NY

Introduction: Combination therapy with endoscopic sleeve gastroplasty (ESG) and pharmacotherapy has become more popular and may increase weight loss compared to ESG alone. However, whether disparities exist in the number of post-procedural follow-ups between the two groups is unclear. This study assessed rates of post-ESG visit compliance in patients who underwent ESG alone compared with those who underwent ESG combined with sequential pharmacotherapy.

Methods: A single-center retrospective study was performed for all patients who underwent ESG at a large academic tertiary care center from June 2021 to September 2023. Demographic data and pharmacotherapy use were assessed. Visit compliance was measured by the number of post-ESG nutrition, gastroenterology nurse practitioner (NP), and gastroenterology physician (MD) visits attended by each patient averaged per year. Pharmacotherapy included semaglutide, phentermine with or without topiramate, bupropion with or without naltrexone, orlistat, liraglutide, metformin, and topiramate alone. Two groups were compared: patients who had ESG alone versus those started on pharmacotherapy either before and/or after ESG.

Results: A total of 136 patients underwent either ESG alone (74, 54%) or ESG combined with sequential pharmacotherapy (62, 46%). Demographic data (ESG alone, ESG with pharmacotherapy) included: female gender (88%, 84%), average age in years at time of ESG (43, 43), pre-ESG weight in pounds (215, 216), and pre-ESG BMI (36.5, 36.3). Notably, the average number of follow-up visits per year was significantly higher for patients who underwent combined ESG and pharmacotherapy compared to ESG alone, attributable to a significant increase in the number of gastroenterology NP and especially MD visits per year. The difference in the number of nutritionist visits/year between the two groups approached significance (Table 1).

Discussion: We found that ESG combined with sequential pharmacotherapy is associated with a significant increase in the average number of follow-up visits per year, specifically gastroenterology MD and NP visits, compared to ESG alone. This may be attributable to the inherent qualities of prescribing anti-obesity medications. These differences may contribute to disparate outcomes between these two groups described in the literature. Further studies elucidating the etiology of differences in follow-up compliance may help achieve more consistent outcomes between ESG alone and combination therapy.


Disclosures:


Jeong Hoon Kim, MD¹, Jade Wang, MD¹, Kamal Hassan, MD², Enad Dawod, MD¹, Patrick Magahis, BA¹, Anam Rizvi, MD¹, Cynthia O. Akagbosu, MD, MA³, Mark Hanscom, MD¹, SriHari Mahadev, MD³, David L. Carr-Locke, MA, MD, FACG¹, Reem Sharaiha, MD¹, Kartik Sampath, MD¹. P4494 - ESG Combined With Pharmacotherapy is Associated With Greater Patient Visit Compliance Compared to ESG Alone, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.