Efficacy and Safety of Intragastric Balloon (IGB) in Non-alcoholic Fatty Liver Disease (NAFLD): a Comprehensive Review and Meta-analysis

Chandan, Saurabh; Mohan, Babu P.; Khan, Shahab R.; Facciorusso, Antonio; Ramai, Daryl; Kassab, Lena L.; Bhogal, Neil; Asokkumar, Ravishankar; Lopez-Nava, Gortrand; McDonough, Stephanie

doi:10.1007/s11695-020-05084-0

Cited by 33 publications

(28 citation statements)

References 53 publications

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“…Two studies have reported the effects of EBMTs on the histologic liver fibrosis. A randomized sham-controlled trial in Singapore evaluated the efficacy of the BioEnterics intragastric balloon (BIB) in ameliorating histology-confirmed NASH ( 21 When broken down into different types of EBMTs, we found that IGB (the most well-established EBMT available) could improve the level of liver enzymes and histologic NAS significantly, data which are in line with other studies (51,52). A recent meta-analysis demonstrated that the beneficial effects of swallowable IGB on liver enzymes and insulin resistance were no worse than those of endoscopic IGB (52).…”

Section: Discussionsupporting

confidence: 79%

Effects of Bariatric Endoscopy on Non-Alcoholic Fatty Liver Disease: A Comprehensive Systematic Review and Meta-Analysis

Ren

Zhou²,

Zhang³

et al. 2022

Front. Endocrinol.

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Background and objectiveEndoscopic bariatric and metabolic therapies (EBMTs) are emerging minimally invasive therapeutic options for obesity and its related complications, including non-alcoholic fatty liver disease (NAFLD). This study aimed to evaluate the effects of EBMTs on NALFD in patients with obesity.MethodsFour databases were searched until Nov 2021. Randomized controlled trials (RCTs) and observational studies reporting liver-related outcomes following Food and Drug Administration (FDA)-approved and non-FDA-approved EBMTs were included. Liver parameters, metabolic parameters, and weight loss were evaluated. Risk of bias was assessed using the “risk of bias” tool in the Cochrane Collaboration for RCTs and the Methodological Index for Non-Randomized Studies criteria for observational studies.ResultsThirty-three studies with 1710 individuals were included. Regarding the effects of EBMTs on liver fibrosis, a significant decline of NAFLD Fibrosis Score, but not transient elastography-detected liver stiffness or Fibrosis-4 Index, was observed. EBMTs significantly improved liver steatosis (control attenuation parameter and Hepatic Steatosis Index), NAFLD Activity Score, and Homeostasis Model Assessment of Insulin Resistance. EBMTs reduced serum levels of alanine transaminase, aspartate aminotransferase, and gamma-glutamyl transpeptidase considerably. Moreover, EBMTs had reducing effects on the serum levels of triglycerides and total cholesterol as well as body weight.ConclusionsOur meta-analysis suggested that EBMTs could ameliorate NAFLD based on the evidence of improved liver steatosis, liver function, and insulin resistance. Large-scale, prospective, long-term studies are warranted to clarify the role of EBMTs in patients with different stages of NAFLD.

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Section: Discussionsupporting

confidence: 79%

Effects of Bariatric Endoscopy on Non-Alcoholic Fatty Liver Disease: A Comprehensive Systematic Review and Meta-Analysis

Ren

Zhou²,

Zhang³

et al. 2022

Front. Endocrinol.

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“…Efficacy and safety of intragastric balloons have been shown for NAFLD in a systematic review and metaanalysis of nine studies including 442 balloons. 356 -691 placement, furthermore, blood glucose, HbA1c, FIB-4, liver stiffness, and CAP were significantly improved. Gastroesophageal reflux symptoms were a side effect, but no severe adverse events occurred.…”

Section: Grade Of Recommendation 0 -Strong Consensus 100% Agreement C...mentioning

confidence: 94%

“…However, data on patients with CLD is limited. Efficacy and safety of intragastric balloons have been shown for NAFLD in a systematic review and meta‐analysis of nine studies including 442 balloons 356 . Improvement of steatosis was observed in 79.2% of the patients and NAFLD activity score in 83.5%.…”

Section: Chronic Liver Diseasementioning

confidence: 99%

European guideline on obesity care in patients with gastrointestinal and liver diseases – Joint European Society for Clinical Nutrition and Metabolism / United European Gastroenterology guideline

et al. 2022

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“…A thorough meta-analysis 87 included 10 published studies on the impact of Orbera IGBs on NAFLD resolution, revealed a mean reduction in the participants' body weight of 11.9 kg, with a significant ( p = 0.03) histological improvement in NAS with a mean score of 2 ± 0.75 versus 4 ± 2.25 in the control sham group, after 6 months of follow-up. 87 Also, Chandan et al 88 conducted a systematic review to evaluate the efficacy of Orbera IGB on NAFLD. The review included nine studies and shows that 79.2% of patients had improvement in steatosis while 83.5% improved in NAS score.…”

Section: Management Of Obesity In Patients With Nafldmentioning

confidence: 99%

Management of Obesity and Nonalcoholic Fatty Liver Disease: A Literature Review

2021

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With the recent urbanization and globalization, the adult obesity rate has been increasing, which was paralleled with a dramatic surge in the incidence and prevalence of nonalcoholic fatty liver disease (NAFLD). NAFLD poses a growing threat to human health as it represents the most common cause of chronic liver disease in developed countries. It encompasses a wide spectrum of conditions starting from a build-up of fat in hepatocytes (steatosis), to developing inflammation (steatohepatitis), and reaching up to cirrhosis. It is also associated with higher rates of cardiovascular mortalities. Therefore, proper timely treatment is essential and weight loss remains the cornerstone in the treatment of obesity-related liver diseases. When diet, exercise, and lifestyle changes are not successful, the current recommendation for weight loss includes antiobesity medications and bariatric endoscopic and surgical interventions. These interventions have shown to result in significant weight loss and improve liver steatosis and fibrosis. In the current literature review, we highlight the expected outcomes and side effects of the currently existing options to have a weight-centric NAFLD approach.

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Efficacy and Safety of Intragastric Balloon (IGB) in Non-alcoholic Fatty Liver Disease (NAFLD): a Comprehensive Review and Meta-analysis

Cited by 33 publications

References 53 publications

Effects of Bariatric Endoscopy on Non-Alcoholic Fatty Liver Disease: A Comprehensive Systematic Review and Meta-Analysis

Effects of Bariatric Endoscopy on Non-Alcoholic Fatty Liver Disease: A Comprehensive Systematic Review and Meta-Analysis

European guideline on obesity care in patients with gastrointestinal and liver diseases – Joint European Society for Clinical Nutrition and Metabolism / United European Gastroenterology guideline

Management of Obesity and Nonalcoholic Fatty Liver Disease: A Literature Review

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