P4877 - Exploring the Metabolic Benefits of Endoscopic Bariatric Therapies: A Network Meta-Analysis

Raj H. Patel, MD¹, Charmy Parikh, MD², Maurya Patel, MBBS³, Dev Desai, MBBS⁴, Yug Patel, MBBS⁵, Truptesh Kothari, MD^6
1St. Mary Medical Center, Bensalem, PA; ²Mercy Catholic Medical Center, Darby, PA; ³Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India; ⁴Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; ⁵Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India; ⁶University of Rochester Medical Center, Rochester, NY

Introduction: Endoscopic bariatric and metabolic therapy is rapidly advancing, offering less invasive approaches to managing obesity and associated health conditions. These procedures provide an alternative for patients who prefer non-surgical options or are not suitable candidates for traditional bariatric surgery. Our network meta-analysis aims to systematically evaluate the metabolic effects of these innovative endoscopic bariatric techniques.

Methods: A network meta-analysis was conducted with 28 articles including 7520 patients focusing on %TWL,%EWL, HbA1C, Triglycerides, and Waist circumference adhering to Prisma-NMA Guidelines and specific inclusion/exclusion criteria along with bias assessment. Intervention groups considered IGB, ESG, DJBS, DMR, POSE, and lifestyle modifications, compared against baseline measures. Lifestyle modifications served as the comparator for %TWL and %EWL. Statistical analysis was conducted using RevMan 5.3 with Fixed and Random Effect Model tests; significance was set at p< 0.05. For modalities lacking direct comparators, indirect comparisons were made among them. League Tables and Mean Rank Tables were generated post-standardization to indirectly compare experimental groups with each other.

Results: Among the 5 parameters analyzed, ESG demonstrated the most significant reduction in HbA1C, with a mean difference (MD) of -1.17 (-1.78 to -0.56). For Triglycerides, ESG was notably effective, achieving an MD of -48.7 (-80.86 to -16.55). When considering waist circumference, DJBS proved most effective with an MD of -19.58 (-28.99 to -1.16). In terms of %EWL and %TWL, POSE and ESG were the most beneficial, with MDs of -28.71 (-43.42 to -13.99) and -5.59 (-8.91 to -2.27), respectively, compared to Lifestyle modifications. ESG, however, showed poorer performance in %EWL, with an indirect MD of 24.97 (9.56 to 40.38), while DMR had the least impact on %TWL, with a direct MD of 1 (-0.67 to 2.67).

Discussion: Our study underscores the substantial metabolic benefits offered by advanced endoscopic bariatric therapies. These findings emphasize their potential efficacy as feasible alternatives to conventional methods for addressing obesity-related health conditions. As these techniques continue to evolve, further research is warranted to refine their comparative effectiveness and long-term outcomes, ultimately guiding personalized treatment strategies in clinical practice.



Disclosures:


Raj H. Patel, MD¹, Charmy Parikh, MD², Maurya Patel, MBBS³, Dev Desai, MBBS⁴, Yug Patel, MBBS⁵, Truptesh Kothari, MD⁶. P4877 - Exploring the Metabolic Benefits of Endoscopic Bariatric Therapies: A Network Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.