Intragastric injection of botulinum toxin A for weight loss: A systematic review and meta-analysis of randomized controlled trials.

Autor: Yen YA; School of Medicine and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan., Wang CC; School of Medicine and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan., Sung WW; School of Medicine and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.; Department of Urology, Chung Shan Medical University Hospital, Taichung, Taiwan., Fang KC; Division of Gastroenterology, Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan., Huang SM; Division of Gastroenterology and Hepatology, Jen-Ai Hospital, Taichung, Taiwan., Lin CC; Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.; School of Medicine, China Medical University, Taichung, Taiwan., Tsai MC; School of Medicine and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan., Yang TW; School of Medicine and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.; Weight Management Center, Chung Shan Medical University Hospital, Taichung, Taiwan.
Jazyk: angličtina
Zdroj: Journal of gastroenterology and hepatology [J Gastroenterol Hepatol] 2022 Jun; Vol. 37 (6), pp. 983-992. Date of Electronic Publication: 2022 Apr 22.
DOI: 10.1111/jgh.15847
Abstrakt: Background and Aim: Intragastric botulinum toxin A (BTA) injection is a potential treatment for weight reduction in obese patients. Current studies yielded conflicting results. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the efficacy of intragastric BTA injection for weight management.
Methods: We searched several databases to identify RCTs evaluating intragastric BTA injections for obesity. We applied random-effects models for all meta-analyses due to heterogeneity in the included studies. The mean difference (MD) and 95% confidence interval (CI) were calculated for continuous outcomes.
Results: A total of 6 RCTs including 192 subjects met the inclusion criteria and were included for the meta-analysis. Although the pooled data from six studies showed no difference in the absolute weight loss between intragastric BTA injection and control, subgroup analysis showed a significantly decreased absolute weight after a BTA injection dose ≥ 200 U (MD, -2.04 kg; 95% CI, -3.96 to -0.12) and after multiple injection regions in the stomach combined with diet control (MD, -4.44 kg; 95% CI, -6.54 to -2.33 kg) compared with the control. Regarding absolute weight loss, the impact of endoscopic ultrasound-guided injection and follow-up duration showed no difference. Intragastric BTA injection had a significant change in body mass index (MD, -1.25 kg/m 2 ; 95% CI, -2.18 to -0.32 kg/m 2 ) and prolonged gastric half-emptying time (MD, 11.37 min; 95% CI, -3.69 to 19.06 min).
Conclusion: Intragastric BTA injection is effective for obesity treatment, and adequate doses (≥ 200 U), multiple gastric injection regions, and combined diet control are crucial. However, given the small sample size and limited power, caution should be exercised.
(© 2022 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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